Retrospective or prospective cohort studies examining NAFLD (as detected either by ultrasonography or by CT) as a risk factor for incident T2DM
| Authors, year (ref.) | Country | Sample size | Follow-up (median, years) | T2DM diagnosis | T2DM% at follow-up | Adjusted OR(s) (±95% CI) | Adjusted variables |
|---|---|---|---|---|---|---|---|
| Okamoto et al, 2003124 | Japan | 840 | 10.0 | FBG ≥140 mg/dL (≥7.8 mmol/L) or HbA1c ≥6.5% or T2DM medications | 14.1% (men) 4.3% (women) | 1.8 (0.9 to 3.5) | Age, sex, BMI, weight gain, FBG, HbA1c, alcohol intake, family history of diabetes |
| Kim et al, 2008122 | South Korea | 5372 | 5.0 | FBG ≥126 mg/dL (≥7.0 mmol/L) or T2DM medications or past history | 4.3% | 1.5 (1.1 to 2.2) | Age, sex, BMI, smoking, family history of diabetes, ALT, FBG, triglycerides, HDL-cholesterol |
| Yamada et al, 2010128 | Japan | 12 375 | 5.0 | FBG ≥126 mg/dL or T2DM medications | 1% (men) | 1.9 (1.9 to 2.8) men | Age, BMI, blood pressure, alcohol intake, smoking |
| 0.5% (women) | 2.1 (2.5 to 4.7) women | ||||||
| Sung and Kim, 2011127 | South Korea | 11 091 | 5.0 | Not reported | 1.6% | 2.05 (1.35 to 3.12) | Age, sex, BMI, alcohol, education, smoking, exercise |
| Chang et al, 2013119 | South Korea | 38 291 | 5.1 | FBG ≥126 mg/dL or HbA1c ≥6.5% or T2DM medications | 1.1% annual incidence | 2.0 (1.8 to 2.2) for low NFS 4.7 (3.7 to 6.1) for intermediate/high NFS | Sex, smoking, alcohol intake, exercise, family history of diabetes, total cholesterol, triglycerides, HDL-cholesterol, CRP, HOMA-insulin resistance |
| Park et al, 2013125 | South Korea | 25 232 (men) | 5.0 | FBG ≥126 mg/dL or HbA1c ≥6.5% or T2DM medications or past history | 8.4% | 1.73 (1.00 to 3.01) | Age, waist circumference, triglycerides, HDL-cholesterol, CRP, HOMA-insulin resistance, creatinine, blood pressure, family history of diabetes, exercise, MetS |
| Shah et al, 2015126 | USA | 3153 | 9.1 | FBG ≥126 mg/dL or T2DM medications or past history | 6.9% | 2.06 (1.52 to 2.79)* | Age, sex, race, BMI, waist circumference, family history of diabetes, blood pressure, FBG, HDL-cholesterol, triglycerides, exercise, CRP, statin use |
| Yamazaki et al, 2015129 | Japan | 4604 | 11.3 | FBG ≥126 mg/dL or HbA1c ≥6.5% or T2DM medications or past history | 6.1% | 2.37 (1.60 to 3.52) | Age, sex, BMI, impaired fasting glycaemia, family history, dyslipidaemia, blood pressure, exercise |
| Ming et al, 2015123 | China | 508 | 5.0 | FBG ≥126 mg/dL or 2-hour OGTT ≥200 mg/dL or T2DM medications | 3.9% | 4.46 (1.86 to 10.73) | Age, sex, BMI, education, smoking, alcohol intake, exercise, family history, blood pressure, FBG, HDL-cholesterol, triglycerides |
| Chen et al, 2016120 | China | 6542 | 6.0 | FBG ≥126 mg/dL or T2DM medications or past history | 5.6% | 2.17 (1.53 to 3.01)* | Age, BMI, triglycerides, impaired fasting glycaemia status |
| Fukada et al, 2016121 | Japan | 4629 | 12.8 | FBG ≥126 mg/dL or HbA1c ≥6.5% or T2DM medications | 7.6% | 3.6 (2.1 to 5.8) for lean 6.8 (5.2 to 8.9) for obese | Age, sex, smoking, alcohol intake, exercise, HbA1c, family history of diabetes |
Only cohort studies with a median follow-up period of at least 5 years are presented. The study by Shah et al is the only one in which the diagnosis of NAFLD was based on CT. The study by Ming et al is the only one in which the diagnosis of diabetes mellitus was also based on 2-hour OGTT glucose levels.
*HR presented.
ALT, alanine aminotransferase; BMI, body mass index; CRP, C reactive protein; FBG, fasting blood glucose; HbA1c, haemoglobin A1c; HDL, high-density lipoprotein; HOMA, homoeostasis model assessment; MetS, metabolic syndrome; NAFLD, non-alcoholic fatty liver disease; NFS, NAFLD fibrosis score; OGTT, oral glucose tolerance test; T2DM, type 2 diabetes mellitus.