Wednesday, July 24, 2013

Getting rid of Fatty Liver Cuts Diabetes Risk

When fatty liver disease is cured, it takes with it a patient's risk of developing diabetes.

In a study in South Korea, patients whose nonalcoholic fatty liver disease (NAFLD) resolved over a 5-year period no longer had an increased risk of incident diabetes. But for those who had worsening NAFLD, the risk of incident diabetes over 5 years was significantly increased.

Even though the study could not address causal relationships, these data strongly suggest that NAFLD severity is associated with a greater risk of diabetes, and attenuation of fatty liver status decreases risk of developing diabetes.

Fatty liver disease has been associated with an increased risk of type 2 diabetes, but it's not clear whether that risk remains elevated when fatty liver resolves.

To assess the hypothesis, researchers in South Korea conducted a retrospective analysis of 13,218 patients who didn't have diabetes at baseline from a Korean occupational cohort. NAFLD was assessed at baseline and after 5 years.

During follow-up, 234 patients developed incident diabetes. NAFLD resolved in 828 patients, developed in 1,640, and progressed from mild to moderate/severe in 324 patients.

Of the 828 patients whose fatty liver disease vanished, only 12 developed incident diabetes. After adjusting for factors including age, sex, glucose, insulin, body mass index (BMI), cholesterol, and others, the researchers found no increased risk of incident diabetes for patients whose fatty liver resolved.

For this group, risk of incident diabetes was similar to that seen in patients who didn't have fatty liver, either at baseline or at follow-up.

On the other hand, patients who developed new NAFLD over the 5-year study period did have an increased risk of incident diabetes.

But risk was highest for patients whose NAFLD worsened over those 5 years, with a "marked" increase in risk of incident diabetes.
The researchers concluded that the data "strongly support the notion that increases or decreases in liver fat influence glucose homeostasis."


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