Journal Article Epublish
PubMed: 39615896 DOI: 10.1136/bmjgast-2024-001466
Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study.
BMJ Open Gastroenterol 11(1)
Authors: Leen Heyens, Hanna Kenjic, Pieter Dagnelie, Casper Schalkwijk, Coen Stehouwer, Steven Meex, Jeroen Kooman, Otto Bekers, Marleen van Greevenbroek, Hans Savelberg, Geert Robaeys, Bastiaan de Galan, Annemarie Koster, Martien van Dongen, Simone Eussen, Ger Koek
Affiliations
- Hasselt University Faculty of Medicine and Life Sciences, Diepenbeek, Belgium.
- Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, The Netherlands.
- School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
- CARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The Netherlands.
- Maastricht University Medical Centre+ Internal Medicine, Maastricht, The Netherlands.
- Department Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, The Netherlands.
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands.
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
- School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
Abstract
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 (Stβ) 0.396, 95% CI 0.323 to 0.471) and FI (Stβ 0.145, 95% CI 0.059 to 0.232) but not FIB-4. T2DM was significantly associated with FLI (Stβ 0.623, 95% CI 0.552 to 0.694) and FI (Stβ 0.307, 95% CI 0.226 to 0.388) but not FIB-4. SAF was significantly associated with FLI (Stβ 0.083, 95% CI 0.036 to 0.129), FI (Stβ 0.106, 95% CI 0.069 to 0.143) and FIB-4 (Stβ 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.
MeSH
Diabetes Mellitus, Fibrosis, Non-Alcoholic Fatty Liver Disease, Liver, Gastrointestinal Diseases, Fatty Liver, Diabetes Mellitus, Type 2