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Epidemiology

Reappraisal of attenuated insulin sensitivity in the evolution of non-alcoholic fatty liver disease

European Journal of Clinical Nutrition volume 73, pages 770–775 (2019)Cite this article

Subjects

Abstract

Background/objectives

It has been unknown if attenuated insulin sensitivity (Si) in non-alcoholic fatty liver disease (NAFLD) is a cause or a result. We examined the impact of attenuated Si on NAFLD evolution.

Subjects/methods

We observed 4856 NAFLD- and diabetes-free participants for a mean 2.9 years. Si was indexed by single point insulin sensitivity estimator (SPISE = [600 × HDL-c0.185]/[TG0.2 × BMI1.338]), correlating with 1/HOMA-IR in an independent cohort (n = 1537, Spearman rho = 0.519, P < 0.01). Fatty liver (FL) was diagnosed by ultrasonography and diabetes by fasting plasma glucose (FPG) ≥ 7 mmol/L and/or glycohemoglobin A1c ≥ 6.5%. Multinominal comparison was performed with incident FL (FLw/oDM, n = 486), diabetes (DMw/oFL, n = 171), and FL plus diabetes (FL/diabetes, n = 58) as targets; none of the above (n = 4,138) was the control. SPISE was taken as a predictor with adjustment for covariates. Trajectory of SPISE during the 5 years before development of each condition was also assessed.

Results

With SPISE tertile 3 (>10.06) as the reference, tertile 1 (<8.07) was related to incident FLw/oDM and FL/diabetes with OR (95% CI) 3.47 (2.60–4.63) and 1.78 (1.10–2.87), respectively, and tertile 2 (8.07–10.06) related to FLw/oDM with OR (95% CI) 1.38 (1.03–1.85). Low SPISE was not significantly related to incident diabetes. At −5 years, SPISE was 12% (P < 0.05) and 13% (P < 0.01) lower in those developed FLw/oDM and FL/diabetes, respectively, than the control. At year 0, SPISE in the two groups was 18% and 21% lower than the control, respectively (P < 0.01).

Conclusions

Attenuation of Si indexed by SPISE was a risk factor for NAFLD.

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Acknowledgements

The authors thank Yoshiko Shishido for the expertise in liver ultrasonography examinations.

Author contributions

T.M., M.S., S.U., K.K. and T.A. conceived and designed the study; T.M., H.S., Y.S., K.H., H.K., K.Y. and T.A. generated, collected, assembled, analysed and/or interpreted data. T.M., K.Y., K.K. and T.A. drafted and revised the manuscript and approved the final version of the manuscript.

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Authors and Affiliations

  1. Diabetes Center, Aizawa Hospital, Matsumoto, Japan

    Takahiro Miyakoshi, Hiroyuki Sagesaka, Yuka Sato, Koh Yamashita & Toru Aizawa

  2. Health Center, Aizawa Hospital, Matsumoto, Japan

    Kazuko Hirbayashi & Hideo Koike

  3. Department of Gastroenterology, Aizawa Hospital, Matsumoto, Japan

    Seiichi Usuda & Kendo Kiyosawa

  4. Takara Clinic, Nagokuma Kanae 2511, Iida, Japan

    Masanori Shimodaira

Authors
  1. Takahiro Miyakoshi
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  2. Hiroyuki Sagesaka
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Correspondence to Toru Aizawa.

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Miyakoshi, T., Sagesaka, H., Sato, Y. et al. Reappraisal of attenuated insulin sensitivity in the evolution of non-alcoholic fatty liver disease. Eur J Clin Nutr 73, 770–775 (2019). https://doi.org/10.1038/s41430-018-0246-3

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