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


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Cuthbertson, DJ, Koskinen, J, Brown, E, Magnussen, CG ORCID: 0000-0002-6238-5730, Hutri-Kahonen, N, Sabin, M, Tossavainen, P, Jokinen, E, Laitinen, T, Viikari, J, Raitakari, OT and 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 , doi: 10.1080/07853890.2021.1956685.

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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 (2), overweight (≥25–2), or obese (≥30 kg/m2) and FLI (as high FLI ≥60 or low FLI 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.

Item Type: Article
Authors/Creators:Cuthbertson, DJ and Koskinen, J and Brown, E and Magnussen, CG and Hutri-Kahonen, N and Sabin, M and Tossavainen, P and Jokinen, E and Laitinen, T and Viikari, J and Raitakari, OT and Juonala, M
Keywords: non-alcoholic fatty liver disease, metabolic syndrome, obesity, risk, type 2 diabetes
Journal or Publication Title: Annals of Medicine
Publisher: Informa Healthcare
ISSN: 0785-3890
DOI / ID Number: 10.1080/07853890.2021.1956685
Copyright Information:

Copyright 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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