Ramos-Lopez Omar, Martinez-Urbistondo Diego, Navas-Carretero Santiago, Zhu Ruixin, Huttunen-Lenz Maija, Stratton Gareth, Handjieva-Darlenska Teodora, Handjiev Svetoslav, Sundvall Jouko Ensio, Silvestre Marta P, Jalo Elli, Pietiläinen Kirsi H, Adam Tanja C, Westerterp-Plantenga Margriet, Simpson Elizabeth, MacDonald Ian, Taylor Moira A, Poppitt Sally D, Schlicht Wolfgang, Brand-Miller Jennie, Fogelholm Mikael, Raben Anne, Martinez J Alfredo
Medicine and Psychology School, Autonomous University of Baja California, Tijuana 22390, Baja California, Mexico.
Internal Medicine Department, Clinica Universidad de Navarra, 28027 Madrid, Spain.
Diagnostics (Basel). 2024 Dec 23;14(24):2895. doi: 10.3390/diagnostics14242895.
Glucose homeostasis may be dependent on liver conditions and influence health-related markers and quality of life (QoL) objective measurements. This study aimed to analyze the interactions of glycemia with liver and health status in a prediabetic population.
This study included 2220 overweight/obese prediabetics from the multinational PREVIEW project. Anthropometrics; clinical, metabolic and other health-related markers; and QoL variables were analyzed. Univariate and multilinear-adjusted regression models were run to explain the interrelationships and effect modification between glycemia, health-related QoL (applying SF-12) and metabolic/liver health (using the HSI, a putative marker of fatty liver).
Relevant age/sex interactions were found concerning the levels of insulin, HOMA-IR, C peptide and transaminases in this prediabetic population. Multivariate models identified age, sex, glucose, WC and QoL as important predictors of HSI variability (adj. R value = 0.1393, < 0.001), whereas the QoL status was statistically related to age, sex, HOMA-IR and HSI (adj. R value = 0.1130, < 0.001) in this glycemia-impaired group. Furthermore, the QoL values declined with increased HSI scores, where a significant interaction was found ( = 0.011) when the data were analyzed when comparing lower glycemia vs. higher glycemia in prediabetics. Indeed, an effect modification was featured depending on the glycemia levels concerning the QoL and HSI worsening.
Glycemia associations with the QoL status and liver metabolism markers were evidenced, with clinical implications for diabetes and liver disease precision management given the modification of the QoL outcomes depending on the liver status and glycemia concentrations. Notably, independent associations of circulating glucose with age, sex, adiposity, inflammation and C peptide levels were found.
葡萄糖稳态可能取决于肝脏状况，并影响与健康相关的指标和生活质量（QoL）客观测量值。本研究旨在分析糖尿病前期人群中血糖与肝脏及健康状况之间的相互作用。
本研究纳入了来自多国PREVIEW项目的2220名超重/肥胖糖尿病前期患者。对人体测量学指标、临床、代谢及其他与健康相关的指标以及生活质量变量进行了分析。采用单变量和多线性调整回归模型来解释血糖、与健康相关的生活质量（应用SF-12量表）和代谢/肝脏健康（使用HSI，一种推测的脂肪肝标志物）之间的相互关系和效应修正。
在该糖尿病前期人群中，发现胰岛素、HOMA-IR、C肽和转氨酶水平存在相关的年龄/性别交互作用。多变量模型确定年龄、性别、血糖、腰围和生活质量是HSI变异性的重要预测因素（调整后R值 = 0.1393，P < 0.001），而在这个血糖受损组中，生活质量状况与年龄、性别HOMA-IR和HSI在统计学上相关（调整后R值 = 0.1130，P < 0.001）。此外，生活质量值随HSI评分增加而下降，在比较糖尿病前期患者低血糖与高血糖时分析数据时发现了显著的交互作用（P = 0.011）。实际上，根据血糖水平，生活质量和HSI恶化存在效应修正。
血糖与生活质量状况和肝脏代谢标志物之间的关联得到了证实，鉴于生活质量结果根据肝脏状况和血糖浓度而改变，这对糖尿病和肝病的精准管理具有临床意义。值得注意的是，发现循环葡萄糖与年龄、性别、肥胖、炎症和C肽水平存在独立关联。
