Variability in fasting blood sugar levels linked to NAFLD development: Study
Korea: Patients with increased long-term fasting plasma glucose (FPG) variability are at increased risk of nonalcoholic fatty liver disease (NAFLD) development, according to a recent study in the Diabetes Research and Clinical Practice.
Glycemic variability (GV) is defined as oscillations in blood sugar levels. It is an important component of glucose homeostasis and is emerging as a critical variable for the assessment of glycemic control.
Some recent studies have suggested an association between blood sugar variability and the development of type 2 diabetes (T2D) and cardiovascular disease (CVD) in people without diabetes. However, there has been no evaluation of the impact of long-term variability in fasting blood sugar levels on the incident NAFLD.
Against the above background, So-hyeon Hong, Ewha Womans University College of Medicine, Seoul, Republic of Korea, and colleagues aimed to investigate impact of glycemic variability in fasting blood sugar on the development of nonalcoholic fatty liver disease.
The study included 57,636 Korean men and women without NAFLD and diabetes mellitus from the Korean National Health Insurance System cohort. The variability in FPG was calculated using the coefficient of variation (FPG-CV), standard deviation (FPG-SD), variability independent of the mean (FPG-VIM), and average successive variability (FPG-ASV).
Key findings of the study include:
· The cumulative incidence of NAFLD demonstrated progressively increasing trends according to the higher quartiles of FPG variability in Kaplan-Meier curves.
· A multivariable Cox proportional hazard analysis revealed that the hazard ratio for incident NAFLD was 1.15 in the highest quartile of FPG-CV compared with the lowest quartile of FPG-CV after adjusting for various confounding factors, including mean FPG levels.
· When using FPG-SD, FPG-VIM, and FPG-ASV, the results were similar.
· The 10-unit increase in FPG variability was associated with a 14% increased risk of NAFLD in the fully adjusted model. Moreover, this effect remained consistent in the subgroup and sensitivity analyses.
"Our findings showed that increased long-term FPG variability is associated with the development of NAFLD, independent of confounding risk variables including mean FPG levels," concluded the authors.
Reference:
The study titled, "Glycemic variability and the risk of nonalcoholic fatty liver disease : A nationwide population-based cohort study," is published in the journal Diabetes Research and Clinical Practice.
DOI: https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(21)00282-5/fulltext
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