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The Relationship between Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease Measured by Controlled Attenuation Parameter.

 Young Eun Chon  ;  Kwang Joon Kim  ;  Kyu Sik Jung  ;  Seung Up Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Chae Yoon Chon  ;  Jae Bock Chung  ;  Kyeong Hye Park  ;  Ji Cheol Bae  ;  Kwang-Hyub Han 
 Yonsei Medical Journal, Vol.57(4) : 885-892, 2016 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adult ; Aged ; Biomarkers/metabolism ; C-Peptide/metabolism ; Case-Control Studies ; Diabetes Mellitus, Type 2/complications* ; Diabetes Mellitus, Type 2/metabolism ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Insulin Resistance ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/epidemiology* ; Non-alcoholic Fatty Liver Disease/metabolism ; Non-alcoholic Fatty Liver Disease/pathology ; Odds Ratio ; Prevalence
Controlled attenuation parameter ; fatty liver ; insulin resistance ; non-alcoholic fatty liver disease ; pre-diabetes ; type 2 diabetes mellitus
PURPOSE: The severity of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) population compared with that in normal glucose tolerance (NGT) individuals has not yet been quantitatively assessed. We investigated the prevalence and the severity of NAFLD in a T2DM population using controlled attenuation parameter (CAP). MATERIALS AND METHODS: Subjects who underwent testing for biomarkers related to T2DM and CAP using Fibroscan® during a regular health check-up were enrolled. CAP values of 250 dB/m and 300 dB/m were selected as the cutoffs for the presence of NAFLD and for moderate to severe NAFLD, respectively. Biomarkers related to T2DM included fasting glucose/insulin, fasting C-peptide, hemoglobin A1c (HbA1c), glycoalbumin, and homeostasis model assessment of insulin resistance of insulin resistance (HOMA-IR). RESULTS: Among 340 study participants (T2DM, n=66; pre-diabetes, n=202; NGT, n=72), the proportion of subjects with NAFLD increased according to the glucose tolerance status (31.9% in NGT; 47.0% in pre-diabetes; 57.6% in T2DM). The median CAP value was significantly higher in subjects with T2DM (265 dB/m) than in those with pre-diabetes (245 dB/m) or NGT (231 dB/m) (all p<0.05). Logistic regression analysis showed that subjects with moderate to severe NAFLD had a 2.8-fold (odds ratio) higher risk of having T2DM than those without NAFLD (p=0.02; 95% confidence interval, 1.21-6.64), and positive correlations between the CAP value and HOMA-IR (ρ0.407) or fasting C-peptide (ρ0.402) were demonstrated. CONCLUSION: Subjects with T2DM had a higher prevalence of severe NAFLD than those with NGT. Increased hepatic steatosis was significantly associated with the presence of T2DM, and insulin resistance induced by hepatic fat may be an important mechanistic connection.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김광준(Kim, Kwang Joon) ORCID logo https://orcid.org/0000-0002-5554-8255
김도영(Kim, Do Young)
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
전재윤(Chon, Chae Yoon)
정규식(Jung, Kyu Sik)
정재복(Chung, Jae Bock)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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