1
|
Ha J, Hong OK, Han K, Kwon HS. Metabolic dysfunction-associated fatty liver disease increases the risk of type 2 diabetes mellitus in young Korean adults. Diabetes Res Clin Pract 2024; 212:111584. [PMID: 38367650 DOI: 10.1016/j.diabres.2024.111584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/19/2024]
Abstract
AIMS To investigate the impact of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) on the risk of type 2 diabetes mellitus in young Korean adults. METHODS Data were sourced from the Korean National Health Insurance Service-Health Screening Cohort, comprising adults aged 20-39 who underwent health examinations between 2009 and 2012. Participants were grouped based on the presence of MAFLD and nonalcoholic fatty liver disease (NAFLD), both individually and in combination. The categorizations included Neither-FLD, NAFLD-only, MAFLD-only, or Both-FLD. Incident diabetes was identified through claims data during the follow-up period. RESULTS Among 6,232,656 participants, 676,747 (10.8 %) had MAFLD. During a median follow-up of 9.5 years, 182,291 incident diabetes cases were identified. Multivariate analysis revealed a significantly higher diabetes risk in the MAFLD group compared to those in the Non-MAFLD group (HR = 6.148, 95 % CI, 6.084-6.212). Notably, diabetes incidence was highest in FLI ≥ 60 subgroup with BMI ≥ 23 and metabolic syndrome. CONCLUSIONS MAFLD is associated with a 6.1-fold increased diabetes risk in young adults, underscoring the urgent need for early intervention to mitigate this risk.
Collapse
Affiliation(s)
- Junchul Ha
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Oak-Kee Hong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
2
|
Miwa T, Tajirika S, Imamura N, Adachi M, Horita R, Hanai T, Ng CH, Siddiqui MS, Fukao T, Shimizu M, Yamamoto M. Usefulness of health checkup-based indices in identifying metabolic dysfunction-associated steatotic liver disease. JGH Open 2024; 8:e13110. [PMID: 38895100 PMCID: PMC11183927 DOI: 10.1002/jgh3.13110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
Aims The application of indices in the context of metabolic dysfunction-associated steatotic liver disease (MASLD) remains unexplored. We aimed to validate the ability of alanine aminotransferase (ALT), fatty liver index (FLI), and hepatic steatosis index (HSI) to identify MASLD during health checkups. Methods We recruited 627 participants and utilized their health checkup data and ultrasound to assess the potential of using ALT, FLI, and HSI as indices for MASLD; this was indicated by the area under the curve (AUC) and restricted cubic spline (RCS) model. The optimal, rule-out (sensitivity ≥90%), and rule-in (specificity ≥90%) cutoff values of each index for identifying MASLD were reported. Results Among participants with a median age of 46 years, the prevalence of MASLD was 28% in total (38% in males and 18% in females). RCS models confirmed a linear association between indices and MASLD. ROC analyses indicated that the AUC of ALT in identifying MASLD was 0.79 for the total cohort, 0.81 for males, and 0.69 for females. The optimal, rule-out, and rule-in cutoff values for ALT were 21, 13, and 29, respectively. Similarly, the AUC of FLI/HSI in identifying MASLD was 0.90/0.88 for the total cohort, 0.86/0.85 for males, and 0.93/0.90 for females. Considering the reference cutoff values, distinct cutoff values were observed between the sexes for FLI, while HSI had similar cutoff values. Conclusion This study demonstrated that ALT > 30 IU/L is a reasonable cutoff value to rule-in MASLD. ALT, FLI, and HSI are reliable indices for identifying MASLD during health checkups.
Collapse
Affiliation(s)
- Takao Miwa
- Health Administration CenterGifu UniversityGifuJapan
- Department of Gastroenterology/Internal Medicine, Graduate School of MedicineGifu UniversityGifuJapan
| | - Satoko Tajirika
- Health Administration CenterGifu UniversityGifuJapan
- Department of Gastroenterology/Internal Medicine, Graduate School of MedicineGifu UniversityGifuJapan
| | | | - Miho Adachi
- Health Administration CenterGifu UniversityGifuJapan
| | - Ryo Horita
- Health Administration CenterGifu UniversityGifuJapan
| | - Tatsunori Hanai
- Department of Gastroenterology/Internal Medicine, Graduate School of MedicineGifu UniversityGifuJapan
| | - Cheng Han Ng
- Division of Gastroenterology and Hepatology, Department of MedicineNational University HospitalSingaporeSingapore
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal MedicineVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Taku Fukao
- Health Administration CenterGifu UniversityGifuJapan
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Graduate School of MedicineGifu UniversityGifuJapan
| | - Mayumi Yamamoto
- Health Administration CenterGifu UniversityGifuJapan
- United Graduate School of Drug Discovery and Medical Information SciencesGifu UniversityGifuJapan
| |
Collapse
|
3
|
Miwa T, Tajirika S, Hanai T, Imamura N, Adachi M, Horita R, Fukao T, Shimizu M, Yamamoto M. Usefulness of a questionnaire for assessing the relationship between eating behavior and steatotic liver disease among Japanese male young adults. Sci Rep 2024; 14:2194. [PMID: 38273030 PMCID: PMC10810865 DOI: 10.1038/s41598-024-52797-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/23/2024] [Indexed: 01/27/2024] Open
Abstract
This study aimed to reveal the relationship between eating behavior and nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) in young adults and suggest a questionnaire for eating behavior assessment. We included 322 male graduate students at Gifu University. Diagnoses of NAFLD and MASLD were based on the presence of hepatic steatosis on ultrasonography. Eating behavior was assessed using the eating behavior questionnaire (EBQ) recommended by the Japan Society for the Study of Obesity. We assessed the eating behaviors associated with NAFLD and MASLD using logistic regression, decision tree, and random forest analyses. The median age of the participants was 22 years, and 16% and 11% had NAFLD and MASLD, respectively. The EBQ total score was significantly higher in participants with MASLD than in those without MASLD (102 vs. 90 points, P = 0.006) and in those with NAFLD than in those without NAFLD (97 vs. 90 points, P = 0.007). Among eating behavior categories, the decision tree and random forest analyses revealed that "perception of constitution and weight" was the strongest contributor for NAFLD/MASLD. Our study revealed that eating behavior assessed with the EBQ is robustly associated with NAFLD and MASLD in young male adults.
Collapse
Affiliation(s)
- Takao Miwa
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan.
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan.
- Gifu University Hospital, Gifu, Japan.
| | - Satoko Tajirika
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
- Gifu University Hospital, Gifu, Japan
| | - Tatsunori Hanai
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
- Gifu University Hospital, Gifu, Japan
| | - Nanako Imamura
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan
| | - Miho Adachi
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan
- Gifu University Hospital, Gifu, Japan
| | - Ryo Horita
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan
- Gifu University Hospital, Gifu, Japan
| | - Taku Fukao
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan
- Gifu University Hospital, Gifu, Japan
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
- Gifu University Hospital, Gifu, Japan
| | - Mayumi Yamamoto
- Health Administration Center, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan
- Gifu University Hospital, Gifu, Japan
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Gifu, Japan
| |
Collapse
|