Distinct Dose-Dependent Association of Free Fatty Acids with Diabetes Development in Nonalcoholic Fatty Liver Disease Patients

Fuxi Li; Junzhao Ye; Yanhong Sun; Yansong Lin; Tingfeng Wu; Congxiang Shao; Qianqian Ma; Xianhua Liao; Shiting Feng; Bihui Zhong

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자료유형: 학술저널

저자정보: Fuxi Li (Sun Yat-sen University) Junzhao Ye (Sun Yat-sen University) Yanhong Sun (Sun Yat-sen University) Yansong Lin (Sun Yat-sen University) Tingfeng Wu (Sun Yat-sen University) Congxiang Shao (Sun Yat-sen University) Qianqian Ma (Sun Yat-sen University) Xianhua Liao (Sun Yat-sen University) Shiting Feng (Sun Yat-sen University) Bihui Zhong (Sun Yat-sen University)

저널정보: 대한당뇨병학회 Diabetes and Metabolism Journal Diabetes and Metabolism Journal Vol.45 No.3

발행연도: 2021.1

수록면: 417 - 429 (13page)

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Background: Excessive delivery of free fatty acids (FFAs) to the liver promotes steatosis and insulin resistance (IR), with IR defined as reduced glucose uptake, glycogen synthesis and anti-lipolysis stimulated by normal insulin levels. Whether the associations between FFAs and diabetes development differ between patients with and without nonalcoholic fatty liver disease (NAFLD) remains unclear. Methods: Consecutive subjects (2,220 NAFLD subjects and 1,790 non-NAFLD subjects according to ultrasound imaging) were enrolled from the First Affiliated Hospital of Sun Yat-sen University between 2009 and 2019. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Results: There was an approximate J-shaped relationship between FFA levels and HOMA-IR in the NAFLD group. Higher FFA concentration quartiles were associated with higher risks of IR (odds ratio [OR], 9.24; 95% confidence interval [CI], 6.43 to 13.36), prediabetes (OR, 10.48; 95% CI, 5.66 to 19.39), and type 2 diabetes mellitus (T2DM; OR, 19.43; 95% CI, 12.75 to 29.81) in the NAFLD group but not in the non-NAFLD group. The cut-off points for the FFA levels increased in a stepwise manner in discriminating IR, prediabetes and T2DM (573, 697, and 715 μmol/L) in the NAFLD group but not in non-NAFLD individuals. Conclusion: A distinct dose-dependent relationship of FFA levels was found with IR, prediabetes and T2DM in NAFLD patients. Screening serum FFA levels in NAFLD patients would be valuable in preventing diabetes development.

#Diabetes mellitus #type 2 #Fatty acids #nonesterifie #Non-alcoholic fatty liver disease

참고문헌 (29)

참고문헌 신청

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Younossi Z / 2018 / Global burden of NAFLD and NASH : trends, predictions, risk factors and prevention / Nat Rev Gastroenterol Hepatol 15:11~20

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Fukuda T / 2016 / The impact of non-alcoholic fatty liver disease on incident type 2 diabetes mellitus in non-overweight individuals / Liver Int 36:275~283

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