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Nonalcoholic fatty liver disease is a risk factor for type 2 diabetes mellitus in middle-aged Japanese men

Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu, Japan

ABSTRACT

OBJECTIVE –: To determine the association between nonalcoholic fatty liver disease (NAFLD) and the risk for development of diabetes.

RESEARCH DESIGN AND METHODS –: We conducted observational cohort study in male workers 40 years old in a Japanese company from 1997 to 2005. We excluded workers with alcohol intake 20 g/day and those with impaired glucose tolerance by 75g oral glucose tolerance test. The remaining 3,189 workers were classified into fatty liver (FL) and non-FL group based on the findings of abdominal ultrasonography. Both groups were followed for the development of diabetes. Hazard ratio (HR) was determined in Cox proportional hazard analysis. A nested case-control study was conducted to determine the odds ratio (OR).

RESULTS –: The average age of participants was 48.0 years at the entry, and the average follow-up period was 4.0 years. The incidence of diabetes in the FL group was 2,073 per 100,000 person-years (65 cases), whereas 452 per 100,000 person-years (44 cases) in non-FL group. The age- and body mass index (BMI)-adjusted HR of diabetes associated with FL was 5.5 (95%CI: 3.6–8.5, P <0.001). In the nested case-control analysis, the OR adjusted for age and BMI was 4.6 (95%CI: 3.0–6.9, P <0.001).

CONCLUSIONS –: NAFLD significantly increases the risk of diabetes in middle-aged Japanese men.

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