A study investigated the relationship between overweight/obesity and fatty liver index (FLI) on the probability of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). 

• The study included 2020 participants, of both genders, aged 24–39 years.
• The enrolled subjects were stratified based on body mass index (BMI), normal weight (<25 kg/m2), overweight (≥25–<30 kg/m2), or obese (≥30 kg/m2) and FLI (as high FLI ≥60 or low FLI <60).
• The incidence of prediabetes/type 2 diabetes and NAFLD (ultrasound assessed) was assessed over 10 years to determine the relative impact of FLI and BMI.

The following observations were made-

• During follow-up, 514 individuals developed prediabetes
• During follow-up, 52 individuals developed type 2 diabetes. 
• Those developing prediabetes or type 2 diabetes were older, with higher BMI, serum glucose, insulin, alanine aminotransferase (ALT) and triglyceride (TG) concentrations contrasting those tho did not develop any. 
• Those with the supplementary appearance of high FLI had a significantly increased risk of developing prediabetes and type 2 diabetes above the risk of being overweight/obese. 
• The overweight/obese, high FLI group had the odds of prediabetes ∼2-fold higher contrasting those with normal weight, low FLI participants. 
• The overweight/obese, high FLI group had the odds of type 2 diabetes 9–10-fold higher contrasting those with normal weight, low FLI participants.
• No difference existed between normal weight, low FLI and overweight/obese and low FLI groups.

It was concluded that FLI is directly proportional to the odds of incident prediabetes, type 2 diabetes and NAFLD in individuals with overweight/obese. Thus, establishing the role of liver fat accumulation in the pathophysiology of prediabetes/type 2 diabetes.

Source: Annals of Medicine, 53:1, 1257-1265, DOI: 10.1080/07853890.2021.1956685