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NAFLD as a risk factor for the development of diabetes and the metabolic syndrome: an eleven-year follow-up study.
Am J Gastroenterol 2009; 104(4):861-7AJ

Abstract

OBJECTIVES

Non-alcoholic fatty liver disease (NAFLD) uncommonly results in cirrhosis and liver-related death; however, its impact on the development of metabolic complications remains unclear. We sought to determine whether NAFLD with elevated aminotransaminase (ALT) levels was a risk factor for incident diabetes or the metabolic syndrome (MS) over an 11-year period.

METHODS

Adult residents of Busselton, Western Australia underwent assessment in 1994-1995 as part of the Busselton Health Survey. NAFLD was diagnosed on the basis of a raised ALT (>40 IU/l) after the exclusion of alcohol, viral, metabolic, and autoimmune liver disease. NAFLD and non-NAFLD subjects were reassessed in 2005 for liver complications, diabetes, and the MS.

RESULTS

A total of 358 subjects, 68% male (109 NAFLD, 249 non-NAFLD), mean age (s.d.) 59.9 (11.6) years, attended follow-up 11.1 years after the initial assessment. After excluding subjects with diabetes at baseline, those with NAFLD were more likely to have developed diabetes on follow-up (20/106, 18.9% vs. 15/246, 6.1%; P<0.001). After excluding subjects with MS at baseline, those with NAFLD were more likely to have developed MS at follow-up (27/81, 33.3% vs. 51/226, 22.6%; P=0.056). However, in multivariate logistic regression models, NAFLD was no longer a significant independent predictor of the development of diabetes or MS after adjusting for baseline waist circumference, hypertension, and insulin resistance. None of the subjects developed liver complications.

CONCLUSIONS

Subjects with NAFLD and elevated ALT levels are at an increased risk of developing diabetes and the MS. This may be because of the presence of associated metabolic risk factors.

Authors+Show Affiliations

School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia. leon.adams@uwa.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19293782

Citation

Adams, Leon A., et al. "NAFLD as a Risk Factor for the Development of Diabetes and the Metabolic Syndrome: an Eleven-year Follow-up Study." The American Journal of Gastroenterology, vol. 104, no. 4, 2009, pp. 861-7.
Adams LA, Waters OR, Knuiman MW, et al. NAFLD as a risk factor for the development of diabetes and the metabolic syndrome: an eleven-year follow-up study. Am J Gastroenterol. 2009;104(4):861-7.
Adams, L. A., Waters, O. R., Knuiman, M. W., Elliott, R. R., & Olynyk, J. K. (2009). NAFLD as a risk factor for the development of diabetes and the metabolic syndrome: an eleven-year follow-up study. The American Journal of Gastroenterology, 104(4), pp. 861-7. doi:10.1038/ajg.2009.67.
Adams LA, et al. NAFLD as a Risk Factor for the Development of Diabetes and the Metabolic Syndrome: an Eleven-year Follow-up Study. Am J Gastroenterol. 2009;104(4):861-7. PubMed PMID: 19293782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - NAFLD as a risk factor for the development of diabetes and the metabolic syndrome: an eleven-year follow-up study. AU - Adams,Leon A, AU - Waters,Oliver R, AU - Knuiman,Matthew W, AU - Elliott,Robert R, AU - Olynyk,John K, Y1 - 2009/03/17/ PY - 2009/3/19/entrez PY - 2009/3/19/pubmed PY - 2009/4/22/medline SP - 861 EP - 7 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 104 IS - 4 N2 - OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) uncommonly results in cirrhosis and liver-related death; however, its impact on the development of metabolic complications remains unclear. We sought to determine whether NAFLD with elevated aminotransaminase (ALT) levels was a risk factor for incident diabetes or the metabolic syndrome (MS) over an 11-year period. METHODS: Adult residents of Busselton, Western Australia underwent assessment in 1994-1995 as part of the Busselton Health Survey. NAFLD was diagnosed on the basis of a raised ALT (>40 IU/l) after the exclusion of alcohol, viral, metabolic, and autoimmune liver disease. NAFLD and non-NAFLD subjects were reassessed in 2005 for liver complications, diabetes, and the MS. RESULTS: A total of 358 subjects, 68% male (109 NAFLD, 249 non-NAFLD), mean age (s.d.) 59.9 (11.6) years, attended follow-up 11.1 years after the initial assessment. After excluding subjects with diabetes at baseline, those with NAFLD were more likely to have developed diabetes on follow-up (20/106, 18.9% vs. 15/246, 6.1%; P<0.001). After excluding subjects with MS at baseline, those with NAFLD were more likely to have developed MS at follow-up (27/81, 33.3% vs. 51/226, 22.6%; P=0.056). However, in multivariate logistic regression models, NAFLD was no longer a significant independent predictor of the development of diabetes or MS after adjusting for baseline waist circumference, hypertension, and insulin resistance. None of the subjects developed liver complications. CONCLUSIONS: Subjects with NAFLD and elevated ALT levels are at an increased risk of developing diabetes and the MS. This may be because of the presence of associated metabolic risk factors. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/19293782/NAFLD_as_a_risk_factor_for_the_development_of_diabetes_and_the_metabolic_syndrome:_an_eleven_year_follow_up_study_ L2 - http://Insights.ovid.com/pubmed?pmid=19293782 DB - PRIME DP - Unbound Medicine ER -