Fatty liver index (FLI) may be an early predictor of type 2 diabetes, suggests a recent study published in the journal Cardiovascular Diabetology.¹

A total of 7777 subjects, aged 40–69 years, from the prospective Korean Genome and Epidemiology Study (KoGES) were enrolled for the present study with an objective to determine the association between fatty liver index and new-onset type 2 diabetes. KoGES, beginning from 2001 and examined until 2013–2014 is investigating the prevalence of risk factors for chronic diseases in Korea and is conducted by the Korean Centers for Disease Control and Prevention (KCDC). None of the participants had diabetes at study entry. The study group included 3676 men and 4101 women. Based on the Fatty liver index score (range 0 to 100), patients were categorized into three groups: low (FLI <30), intermediate (FLI 30-59) and high (FLI ≥ 60). Glycemic status was assessed every two years in all participants.

Over a follow-up period of 12 years, nearly 20% (n=1490) of the study subjects developed type 2 diabetes. After adjusting for potentially confounding cardiometabolic variables, the risk for incident type 2 diabetes was higher for the intermediate and high FLI compared to low FLI. The incidence of type 2 diabetes was increased 6 to 7-folds in the FLI (≥ 60) group with hazard ratios of 6.8 for men and 5.8 for women.

FLI is a marker of fatty liver and combines waist circumference, body mass index, γ-glutamyl transferase and triglycerides. This 12-year study has demonstrated a positive association between FLI and incident type 2 diabetes, which was independent of baseline insulin resistance measured by HOMA-IR (Homeostatic Model Assessment for Insulin Resistance). These findings suggest that a high fatty liver index could be predictive of development of type 2 diabetes even when prior glucose or insulin (HOMA-IR) levels are normal.

Reference

1. Seo IH, et al. Fatty liver index as a predictor for incident type 2 diabetes in community-dwelling adults: longitudinal findings over 12 years. Cardiovasc Diabetol. 2022 Oct 13;21(1):209. doi: 10.1186/s12933-022-01642-1.