TY - JOUR
T1 - Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes
T2 - analysis of The Maastricht Study
AU - Heyens, Leen
AU - Kenjic, Hanna
AU - Dagnelie, Pieter
AU - Schalkwijk, Casper
AU - Stehouwer, Coen
AU - Meex, Steven
AU - Kooman, Jeroen
AU - Bekers, Otto
AU - van Greevenbroek, Marleen
AU - Savelberg, Hans
AU - Robaeys, Geert
AU - de Galan, Bastiaan
AU - Koster, Annemarie
AU - van Dongen, Martien
AU - Eussen, Simone
AU - Koek, Ger
PY - 2024/11/29
Y1 - 2024/11/29
N2 - Objective Glucose metabolism status (GMS) is linked to non-alcoholic fatty liver disease (NAFLD). Higher levels of advanced glycation end products (AGEs) are observed in people with type 2 diabetes mellitus (T2DM) and NAFLD. We examined the association between GMS, non-invasive tests and AGEs, with liver steatosis and fibrosis.Methods Data from The Maastricht Study, a population-based cohort, were analysed. Participants with alcohol overconsumption or missing data were excluded. GMS was determined via an oral glucose tolerance test. AGEs, measured by skin autofluorescence (SAF), were assessed using an AGE Reader. Associations of GMS and SAF with the fibrosis-4 score (FIB-4), Forns index (FI) and fatty liver index (FLI) were investigated using multivariable linear regression, adjusted for sociodemographic, lifestyle and clinical variables.Results 1955 participants (56.6%) were analysed: 598 (30.6%) had T2DM, 264 (13.5%) had pre-diabetes and 1069 (54.7%) had normal glucose metabolism. Pre-diabetes was significantly associated with FLI (standardised regression coefficient (St beta) 0.396, 95% CI 0.323 to 0.471) and FI (St beta 0.145, 95% CI 0.059 to 0.232) but not FIB-4. T2DM was significantly associated with FLI (St beta 0.623, 95% CI 0.552 to 0.694) and FI (St beta 0.307, 95% CI 0.226 to 0.388) but not FIB-4. SAF was significantly associated with FLI (St beta 0.083, 95% CI 0.036 to 0.129), FI (St beta 0.106, 95% CI 0.069 to 0.143) and FIB-4 (St beta 0.087, 95% CI 0.037 to 0.137).Conclusion The study showed that adverse GMS and higher glycaemia are positively associated with steatosis. FI, but not FIB-4, was related to adverse GMS concerning fibrosis. This study is the first to demonstrate that SAF is positively associated with steatosis and fibrosis.
AB - Objective Glucose metabolism status (GMS) is linked to non-alcoholic fatty liver disease (NAFLD). Higher levels of advanced glycation end products (AGEs) are observed in people with type 2 diabetes mellitus (T2DM) and NAFLD. We examined the association between GMS, non-invasive tests and AGEs, with liver steatosis and fibrosis.Methods Data from The Maastricht Study, a population-based cohort, were analysed. Participants with alcohol overconsumption or missing data were excluded. GMS was determined via an oral glucose tolerance test. AGEs, measured by skin autofluorescence (SAF), were assessed using an AGE Reader. Associations of GMS and SAF with the fibrosis-4 score (FIB-4), Forns index (FI) and fatty liver index (FLI) were investigated using multivariable linear regression, adjusted for sociodemographic, lifestyle and clinical variables.Results 1955 participants (56.6%) were analysed: 598 (30.6%) had T2DM, 264 (13.5%) had pre-diabetes and 1069 (54.7%) had normal glucose metabolism. Pre-diabetes was significantly associated with FLI (standardised regression coefficient (St beta) 0.396, 95% CI 0.323 to 0.471) and FI (St beta 0.145, 95% CI 0.059 to 0.232) but not FIB-4. T2DM was significantly associated with FLI (St beta 0.623, 95% CI 0.552 to 0.694) and FI (St beta 0.307, 95% CI 0.226 to 0.388) but not FIB-4. SAF was significantly associated with FLI (St beta 0.083, 95% CI 0.036 to 0.129), FI (St beta 0.106, 95% CI 0.069 to 0.143) and FIB-4 (St beta 0.087, 95% CI 0.037 to 0.137).Conclusion The study showed that adverse GMS and higher glycaemia are positively associated with steatosis. FI, but not FIB-4, was related to adverse GMS concerning fibrosis. This study is the first to demonstrate that SAF is positively associated with steatosis and fibrosis.
KW - Non-alcoholic Fatty Liver Disease
KW - DIABETES MELLITUS
KW - HEPATIC FIBROSIS
KW - GLYCATION END-PRODUCTS
KW - SKIN AUTOFLUORESCENCE
KW - DIAGNOSTIC-ACCURACY
KW - DISEASE
KW - FIBROSIS
KW - RISK
KW - RECEPTOR
KW - INFLAMMATION
KW - AGES
KW - PREVALENCE
U2 - 10.1136/bmjgast-2024-001466
DO - 10.1136/bmjgast-2024-001466
M3 - Article
SN - 2054-4774
VL - 11
JO - BMJ Open Gastroenterology
JF - BMJ Open Gastroenterology
IS - 1
M1 - e001466
ER -