Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD)

Daniel J. Cuthbertson; Juha Koskinen; Emily Brown; Costan G. Magnussen; Nina Hutri-Kähönen; Matthew Sabin; Päivi Tossavainen; Eero Jokinen; Tomi Laitinen; Jorma Viikari; Olli T. Raitakari; Markus Juonala

doi:10.1080/07853890.2021.1956685

Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD)

Daniel J. Cuthbertson, Juha Koskinen, Emily Brown, Costan G. Magnussen, Nina Hutri-Kähönen, Matthew Sabin, Päivi Tossavainen, Eero Jokinen, Tomi Laitinen, Jorma Viikari, Olli T. Raitakari, Markus Juonala

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Abstract

Aims: To investigate the association between overweight/obesity and fatty liver index (FLI) on the odds of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) in 2020 participants after 10 years follow up. Methods: At baseline (in 2001) 2020 participants, males and females, aged 24–39 years, were stratified according to body mass index (BMI), normal weight (<25 kg/m²), overweight (≥25–<30 kg/m²), or obese (≥30 kg/m²) and FLI (as high FLI ≥60 or low FLI <60). We examined the incidence of prediabetes/type 2 diabetes and NAFLD (ultrasound assessed) over 10 years to 2011 to determine the relative impact of FLI and BMI. Results: 514 and 52 individuals developed prediabetes and type 2 diabetes during follow-up. Such individuals were older, with higher BMI, serum glucose, insulin, alanine aminotransferase (ALT) and triglyceride (TG) concentrations than those who did not develop prediabetes or type 2 diabetes (n = 1454). The additional presence of high FLI significantly increased the risk of developing prediabetes and type 2 diabetes above the risk of being overweight/obese. Compared with normal weight, low FLI participants, the odds of prediabetes were ∼2-fold higher and the odds of type 2 diabetes were 9–10-fold higher respectively in the overweight/obese, high FLI group. No difference was observed between normal weight, low FLI and overweight/obese and low FLI groups. Conclusions: An increased FLI significantly increases the odds of incident prediabetes, type 2 diabetes and NAFLD in individuals with overweight/obese highlighting the contributory role of liver fat accumulation in the pathophysiology of prediabetes/type 2 diabetes.Key messages Obesity is a risk factor for non-alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes. Additionally, NAFLD is more prevalent in people with prediabetes and type 2 diabetes when compared to age- and BMI-matched individuals. The presence of a raised fatty liver index (FLI) confers a significantly increased risk of developing prediabetes, type 2 diabetes and NAFLD above that conferred by being overweight/obese. The degree of elevation of FLI can risk stratify for incident prediabetes and type 2 diabetes in people with obesity.

Original language	English
Pages (from-to)	1256-1264
Number of pages	9
Journal	Annals of Medicine
Volume	53
Issue number	1
DOIs	https://doi.org/10.1080/07853890.2021.1956685
Publication status	Published - 2021
Publication type	A1 Journal article-refereed

Funding

The Young Finns Study has been supported by Academy of Finland grants 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi) and 41071 (Skidi); the Social Insurance Institution of Finland; Kuopio, Tampere and Turku University Hospital Medical Funds [grants 9M048 and 9N035]; the Juho Vainio Foundation; the Paavo Nurmi Foundation; the Finnish Foundation for Cardiovascular Research; the Finnish Cultural Foundation; the Tampere Tuberculosis Foundation; and the Emil Aaltonen Foundation. This work was also funded by the National Health and Medical Research Council [grant APP1098369]. C.G.M is supported by a National Heart Foundation of Australia Future Leader Fellowship [100849]. J.K. was supported by Turku University Foundation, Emil Aaltonen Foundation and Urmas Pekkala Foundation

Keywords

metabolic syndrome
Non-alcoholic fatty liver disease
obesity
risk
type 2 diabetes

Publication forum classification

Publication forum level 2

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Fatty liver index predicts incident risk of prediabetes type 2 diabetes and non alcoholic fatty liver disease NAFLDFinal published version, 1.22 MBLicence: CC BY

http://urn.fi/URN:NBN:fi:tuni-202108236706Licence: CC BY

Cite this

Cuthbertson, D. J., Koskinen, J., Brown, E., Magnussen, C. G., Hutri-Kähönen, N., Sabin, M., Tossavainen, P., Jokinen, E., Laitinen, T., Viikari, J., Raitakari, O. T., & Juonala, M. (2021). Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Annals of Medicine, 53(1), 1256-1264. https://doi.org/10.1080/07853890.2021.1956685

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title = "Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD)",

abstract = "Aims: To investigate the association between overweight/obesity and fatty liver index (FLI) on the odds of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) in 2020 participants after 10 years follow up. Methods: At baseline (in 2001) 2020 participants, males and females, aged 24–39 years, were stratified according to body mass index (BMI), normal weight (<25 kg/m2), overweight (≥25–<30 kg/m2), or obese (≥30 kg/m2) and FLI (as high FLI ≥60 or low FLI <60). We examined the incidence of prediabetes/type 2 diabetes and NAFLD (ultrasound assessed) over 10 years to 2011 to determine the relative impact of FLI and BMI. Results: 514 and 52 individuals developed prediabetes and type 2 diabetes during follow-up. Such individuals were older, with higher BMI, serum glucose, insulin, alanine aminotransferase (ALT) and triglyceride (TG) concentrations than those who did not develop prediabetes or type 2 diabetes (n = 1454). The additional presence of high FLI significantly increased the risk of developing prediabetes and type 2 diabetes above the risk of being overweight/obese. Compared with normal weight, low FLI participants, the odds of prediabetes were ∼2-fold higher and the odds of type 2 diabetes were 9–10-fold higher respectively in the overweight/obese, high FLI group. No difference was observed between normal weight, low FLI and overweight/obese and low FLI groups. Conclusions: An increased FLI significantly increases the odds of incident prediabetes, type 2 diabetes and NAFLD in individuals with overweight/obese highlighting the contributory role of liver fat accumulation in the pathophysiology of prediabetes/type 2 diabetes.Key messages Obesity is a risk factor for non-alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes. Additionally, NAFLD is more prevalent in people with prediabetes and type 2 diabetes when compared to age- and BMI-matched individuals. The presence of a raised fatty liver index (FLI) confers a significantly increased risk of developing prediabetes, type 2 diabetes and NAFLD above that conferred by being overweight/obese. The degree of elevation of FLI can risk stratify for incident prediabetes and type 2 diabetes in people with obesity.",

keywords = "metabolic syndrome, Non-alcoholic fatty liver disease, obesity, risk, type 2 diabetes",

author = "Cuthbertson, {Daniel J.} and Juha Koskinen and Emily Brown and Magnussen, {Costan G.} and Nina Hutri-K{\"a}h{\"o}nen and Matthew Sabin and P{\"a}ivi Tossavainen and Eero Jokinen and Tomi Laitinen and Jorma Viikari and Raitakari, {Olli T.} and Markus Juonala",

note = "Funding Information: The Young Finns Study has been supported by Academy of Finland grants 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi) and 41071 (Skidi); the Social Insurance Institution of Finland; Kuopio, Tampere and Turku University Hospital Medical Funds [grants 9M048 and 9N035]; the Juho Vainio Foundation; the Paavo Nurmi Foundation; the Finnish Foundation for Cardiovascular Research; the Finnish Cultural Foundation; the Tampere Tuberculosis Foundation; and the Emil Aaltonen Foundation. This work was also funded by the National Health and Medical Research Council [grant APP1098369]. C.G.M is supported by a National Heart Foundation of Australia Future Leader Fellowship [100849]. J.K. was supported by Turku University Foundation, Emil Aaltonen Foundation and Urmas Pekkala Foundation Publisher Copyright: {\textcopyright} 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",

year = "2021",

doi = "10.1080/07853890.2021.1956685",

language = "English",

volume = "53",

pages = "1256--1264",

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publisher = "Taylor & Francis",

number = "1",

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Cuthbertson, DJ, Koskinen, J, Brown, E, Magnussen, CG, Hutri-Kähönen, N, Sabin, M, Tossavainen, P, Jokinen, E, Laitinen, T, Viikari, J, Raitakari, OT & Juonala, M 2021, 'Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD)', Annals of Medicine, vol. 53, no. 1, pp. 1256-1264. https://doi.org/10.1080/07853890.2021.1956685

TY - JOUR

T1 - Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD)

AU - Cuthbertson, Daniel J.

AU - Koskinen, Juha

AU - Brown, Emily

AU - Magnussen, Costan G.

AU - Hutri-Kähönen, Nina

AU - Sabin, Matthew

AU - Tossavainen, Päivi

AU - Jokinen, Eero

AU - Laitinen, Tomi

AU - Viikari, Jorma

AU - Raitakari, Olli T.

AU - Juonala, Markus

N1 - Funding Information: The Young Finns Study has been supported by Academy of Finland grants 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi) and 41071 (Skidi); the Social Insurance Institution of Finland; Kuopio, Tampere and Turku University Hospital Medical Funds [grants 9M048 and 9N035]; the Juho Vainio Foundation; the Paavo Nurmi Foundation; the Finnish Foundation for Cardiovascular Research; the Finnish Cultural Foundation; the Tampere Tuberculosis Foundation; and the Emil Aaltonen Foundation. This work was also funded by the National Health and Medical Research Council [grant APP1098369]. C.G.M is supported by a National Heart Foundation of Australia Future Leader Fellowship [100849]. J.K. was supported by Turku University Foundation, Emil Aaltonen Foundation and Urmas Pekkala Foundation Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2021

Y1 - 2021

N2 - Aims: To investigate the association between overweight/obesity and fatty liver index (FLI) on the odds of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) in 2020 participants after 10 years follow up. Methods: At baseline (in 2001) 2020 participants, males and females, aged 24–39 years, were stratified according to body mass index (BMI), normal weight (<25 kg/m2), overweight (≥25–<30 kg/m2), or obese (≥30 kg/m2) and FLI (as high FLI ≥60 or low FLI <60). We examined the incidence of prediabetes/type 2 diabetes and NAFLD (ultrasound assessed) over 10 years to 2011 to determine the relative impact of FLI and BMI. Results: 514 and 52 individuals developed prediabetes and type 2 diabetes during follow-up. Such individuals were older, with higher BMI, serum glucose, insulin, alanine aminotransferase (ALT) and triglyceride (TG) concentrations than those who did not develop prediabetes or type 2 diabetes (n = 1454). The additional presence of high FLI significantly increased the risk of developing prediabetes and type 2 diabetes above the risk of being overweight/obese. Compared with normal weight, low FLI participants, the odds of prediabetes were ∼2-fold higher and the odds of type 2 diabetes were 9–10-fold higher respectively in the overweight/obese, high FLI group. No difference was observed between normal weight, low FLI and overweight/obese and low FLI groups. Conclusions: An increased FLI significantly increases the odds of incident prediabetes, type 2 diabetes and NAFLD in individuals with overweight/obese highlighting the contributory role of liver fat accumulation in the pathophysiology of prediabetes/type 2 diabetes.Key messages Obesity is a risk factor for non-alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes. Additionally, NAFLD is more prevalent in people with prediabetes and type 2 diabetes when compared to age- and BMI-matched individuals. The presence of a raised fatty liver index (FLI) confers a significantly increased risk of developing prediabetes, type 2 diabetes and NAFLD above that conferred by being overweight/obese. The degree of elevation of FLI can risk stratify for incident prediabetes and type 2 diabetes in people with obesity.

AB - Aims: To investigate the association between overweight/obesity and fatty liver index (FLI) on the odds of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) in 2020 participants after 10 years follow up. Methods: At baseline (in 2001) 2020 participants, males and females, aged 24–39 years, were stratified according to body mass index (BMI), normal weight (<25 kg/m2), overweight (≥25–<30 kg/m2), or obese (≥30 kg/m2) and FLI (as high FLI ≥60 or low FLI <60). We examined the incidence of prediabetes/type 2 diabetes and NAFLD (ultrasound assessed) over 10 years to 2011 to determine the relative impact of FLI and BMI. Results: 514 and 52 individuals developed prediabetes and type 2 diabetes during follow-up. Such individuals were older, with higher BMI, serum glucose, insulin, alanine aminotransferase (ALT) and triglyceride (TG) concentrations than those who did not develop prediabetes or type 2 diabetes (n = 1454). The additional presence of high FLI significantly increased the risk of developing prediabetes and type 2 diabetes above the risk of being overweight/obese. Compared with normal weight, low FLI participants, the odds of prediabetes were ∼2-fold higher and the odds of type 2 diabetes were 9–10-fold higher respectively in the overweight/obese, high FLI group. No difference was observed between normal weight, low FLI and overweight/obese and low FLI groups. Conclusions: An increased FLI significantly increases the odds of incident prediabetes, type 2 diabetes and NAFLD in individuals with overweight/obese highlighting the contributory role of liver fat accumulation in the pathophysiology of prediabetes/type 2 diabetes.Key messages Obesity is a risk factor for non-alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes. Additionally, NAFLD is more prevalent in people with prediabetes and type 2 diabetes when compared to age- and BMI-matched individuals. The presence of a raised fatty liver index (FLI) confers a significantly increased risk of developing prediabetes, type 2 diabetes and NAFLD above that conferred by being overweight/obese. The degree of elevation of FLI can risk stratify for incident prediabetes and type 2 diabetes in people with obesity.

KW - metabolic syndrome

KW - Non-alcoholic fatty liver disease

KW - obesity

KW - risk

KW - type 2 diabetes

U2 - 10.1080/07853890.2021.1956685

DO - 10.1080/07853890.2021.1956685

M3 - Article

AN - SCOPUS:85111284929

SN - 0785-3890

VL - 53

SP - 1256

EP - 1264

JO - Annals of Medicine

JF - Annals of Medicine

IS - 1

ER -

Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD)

Abstract

Funding

Keywords

Publication forum classification

ASJC Scopus subject areas

UN SDGs

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