Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease
- Author:
Teruki MIYAKE
1
;
Shinya FURUKAWA
;
Bunzo MATSUURA
;
Osamu YOSHIDA
;
Masumi MIYAZAKI
;
Akihito SHIOMI
;
Ayumi KANAMOTO
;
Hironobu NAKAGUCHI
;
Yoshiko NAKAMURA
;
Yusuke IMAI
;
Mitsuhito KOIZUMI
;
Takao WATANABE
;
Yasunori YAMAMOTO
;
Yohei KOIZUMI
;
Yoshio TOKUMOTO
;
Masashi HIROOKA
;
Teru KUMAGI
;
Eiji TAKESITA
;
Yoshio IKEDA
;
Masanori ABE
;
Yoichi HIASA
Author Information
- Publication Type:Original Article
- From:Diabetes & Metabolism Journal 2024;48(3):440-448
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Background:Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.
Methods:This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%.
Results:Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.
Conclusion:Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.
