Indices of Hepatic Steatosis and Fibrosis in Prediabetes and Association with Diabetes Development in the Vitamin D and Type 2 Diabetes Study

作者：K. Corbin, A. Pittas, C. Desouza, Kristine Grdinovac, K. Herzig, S. Kashyap, Sun Kim, J. Nelson, N. Rasouli, Ellen M. Vickery, W. Knowler, R. Pratley · 发表于：Journal of diabetes and its complications · 年份：2023 · DOI：10.1016/j.jdiacomp.2023.108475 · 被引用次数：12 · 研究领域：Medicine

Aims: Non-alcoholic fatty liver disease (NAFLD) is a common comorbidity that leads to poor outcomes in people at high risk for development of type 2 diabetes (T2D). Vitamin D is a possible mediator. In the vitamin D and type 2 diabetes study (D2d), we investigated the relationship of baseline indices of NAFLD with incident T2D and whether vitamin D modified the association. Methods: Cross-sectional associations of indices of NAFLD with glycemia and vitamin D status were assessed in 3,972 individuals screened for the D2d study. In those with prediabetes randomized to vitamin D or placebo (n=2,423), we examined longitudinal associations of NAFLD indices with incident T2DM. We used validated non-invasive scores to assess steatosis [(hepatic steatosis index (HSI); NAFLD-liver fat score (NAFLD-LFS)] and advanced fibrosis [fibrosis-4 (FIB-4) index; AST to Platelet Ratio Index (APRI)]. Results: Eighty-five percent of participants had likely steatosis by HSI and 71% by NAFLD-LFS; 3% were likely to have advanced fibrosis by FIB-4 and 1.2% by APRI. FIB-4 indicated that 20.4% of individuals require further follow up of liver health. Steatosis and fibrosis scores were higher among participants with worse glycemia. The NAFLD-LFS and APRI predicted development of diabetes (hazard ratios [95%CI] 1.35 [1.07, 1.70]; p = 0.012) and 2.36 (1.23, 4.54; p = 0.010), respectively). The effect of vitamin D on diabetes risk was not modified by baseline NAFLD indices. Individuals with likely steatosis ...