Additive effect of non-alcoholic fatty liver disease on the development of diabetes in individuals with metabolic syndrome.
INTRODUCTION
Non-alcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of the metabolic syndrome (MetS), with insulin resistance as the common pathophysiology. In a current longitudinal cohort study, we evaluated the separate and combined effects of MetS and NAFLD on incident diabetes risk.


METHODS
Participants were categorized into four groups on the basis of the presence of NAFLD and MetS at baseline (i.e., with NAFLD, with MetS, with both, or without either). We compared the development of diabetes among these four groups.


RESULTS
During the mean follow up of 4years, 435 of the 7849 participants (5.5%) developed diabetes. The age, sex, and smoking-adjusted risk of incident diabetes was higher in the NAFLD only group (HR 1.51, 95% CI 1.14-1.99), MetS only group (HR 2.82, 95% CI 2.01-3.95), and both group (HR 5.45, 95% CI 4.32-6.82) compared with the group of neither. When compared with the NAFLD only group, the adjusted HR for incident diabetes was 1.87 (95% CI 1.29-2.72) in the MetS only group and 3.62 (95% CI 2.74-4.77) in both group. Among individuals with MetS, the presence of NAFLD showed a significant increase in risk of incident diabetes even after further adjustment for MetS components including fasting glucose, TG, BMI, systolic BP, and HDL-C (HR 1.53, 95% CI 1.09-2.16).


CONCLUSION
The presence of NAFLD further increased the risk of incident diabetes in individuals with metabolic syndrome. Our results suggest that the coexistence of NAFLD has an additive effect on the development of diabetes in individuals with MetS.
['Bae|Ji Cheol|JC|', 'Kim|Soo Kyoung|SK|', 'Han|Ji Min|JM|', 'Kwon|Sam|S|', 'Lee|Da Young|DY|', 'Kim|Jihyun|J|', 'Park|Se Eun|SE|', 'Park|Cheol-Young|CY|', 'Lee|Won-Young|WY|', 'Oh|Ki-Won|KW|', 'Park|Sung-Woo|SW|', 'Rhee|Eun Jung|EJ|']
D000328:Adult D015331:Cohort Studies D048909:Diabetes Complications D005260:Female D006801:Humans D008137:Longitudinal Studies D008297:Male D024821:Metabolic Syndrome D065626:Non-alcoholic Fatty Liver Disease D015995:Prevalence D012189:Retrospective Studies D012307:Risk Factors
Fatty liver Diabetes Metabolic syndrome