INSERM CESP Center for Research in Epidemiology and Population Health, Villejuif, France.
BMC Gastroenterol. 2010 Jun 7;10:56. doi: 10.1186/1471-230X-10-56.
Fatty liver is known to be linked with insulin resistance, alcohol intake, diabetes and obesity. Biopsy and even scan-assessed fatty liver are not always feasible in clinical practice. This report evaluates the predictive ability of two recently published markers of fatty liver: the Fatty Liver Index (FLI) and the NAFLD fatty liver score (NAFLD-FLS), for 9-year incident diabetes, in the French general-population cohort: Data from an Epidemiological Study on the Insulin Resistance syndrome (D.E.S.I.R).
At baseline, there were 1861 men and 1950 women, non-diabetic, aged 30 to 65 years. Over the follow-up, 203 incident diabetes cases (140 men, 63 women) were identified by diabetes-treatment or fasting plasma glucose > or = 7.0 mmol/l. The FLI includes: BMI, waist circumference, triglycerides and gamma glutamyl transferase, and the NAFLD-FLS: the metabolic syndrome, diabetes, insulin, alanine aminotransferase, and asparate aminotransferase. Logistic regression was used to determine the odds ratios for incident diabetes associated with categories of the fatty liver indices.
In comparison to those with a FLI < 20, the age-adjusted odds ratio (95% confidence interval) for diabetes for a FLI > or = 70 was 9.33 (5.05-17.25) for men and 36.72 (17.12-78.76) for women; these were attenuated to 3.43 (1.61-7.28) and 11.05 (4.09 29.81), after adjusting on baseline glucose, insulin, hypertension, alcohol intake, physical activity, smoking and family antecedents of diabetes; odds ratios increased to 4.71 (1.68-13.16) and 22.77 (6.78-76.44) in those without an excessive alcohol intake. The NAFLD-FLS also predicted incident diabetes, but with odds ratios much lower in women, similar in men.
These fatty liver indexes are simple clinical tools for evaluating the extent of liver fat and they are predictive of incident diabetes. Physicians should screen for diabetes in patients with fatty liver.
脂肪肝与胰岛素抵抗、饮酒、糖尿病和肥胖有关。在临床实践中，并非总是可行进行肝活检甚至扫描评估脂肪肝。本报告评估了两种最近发表的脂肪肝标志物：脂肪肝指数（FLI）和非酒精性脂肪性肝病脂肪肝评分（NAFLD-FLS），在法国普通人群队列中的 9 年新发糖尿病中的预测能力：来自胰岛素抵抗综合征的流行病学研究（D.E.S.I.R.）的数据。
在基线时，有 1861 名男性和 1950 名女性，非糖尿病，年龄 30 至 65 岁。在随访期间，通过糖尿病治疗或空腹血糖>或=7.0mmol/l 确定了 203 例新发糖尿病病例（140 例男性，63 例女性）。FLI 包括：BMI、腰围、甘油三酯和γ-谷氨酰转移酶，NAFLD-FLS：代谢综合征、糖尿病、胰岛素、丙氨酸氨基转移酶和天冬氨酸氨基转移酶。使用逻辑回归确定与脂肪肝指数类别相关的新发糖尿病的比值比（95%置信区间）。
与 FLI<20 的人相比，FLI>或=70 的男性和女性的糖尿病年龄调整比值比（95%置信区间）分别为 9.33（5.05-17.25）和 36.72（17.12-78.76）；这些在调整基线葡萄糖、胰岛素、高血压、饮酒、体力活动、吸烟和糖尿病家族史后分别减弱至 3.43（1.61-7.28）和 11.05（4.09-29.81）；在没有过量饮酒的情况下，比值比增加至 4.71（1.68-13.16）和 22.77（6.78-76.44）。NAFLD-FLS 也预测了新发糖尿病，但女性的比值比低得多，男性相似。
这些脂肪肝指数是评估肝脏脂肪程度的简单临床工具，可预测新发糖尿病。医生应在脂肪肝患者中筛查糖尿病。
