Poor clinical outcomes observed in MASLD patients with 1-hr plasma glucose over 8.6 mmol/L, reveals study

A new study published in the journal of Diabetes Research and Clinical Practice showed that metabolic dysfunction may be defined by a 1-hour plasma glucose (PG) level of ≥8.6 mmol/L in metabolic dysfunction-associated steatotic liver disease (MASLD).

Over one-third of the general population suffers from metabolic dysfunction-associated steatotic liver disease, formerly known as nonalcoholic fatty liver disease (NAFLD), which has grown to be a major global public health problem. A poor profile of metabolic and inflammatory abnormalities, including obesity, type 2 diabetes mellitus (T2DM), hyperlipidemia, hypertension, and cardiovascular disease (CVD), is evident in MASLD.

The International Diabetes Federation Position Statement has suggested a 1-hour PG value of  ≥ 8.6 mmol/L as an extra diagnostic criteria for diabetes. This value is a more sensitive indicator of long-term cardiovascular problems associated with diabetes mellitus than standard glucose indicators. Its worth in MASLD is yet unknown, though. Thus, Long Teng and colleagues carried out a cross-sectional study in a Chinese population to determine the potential value of using 1-h PG ≥ 8.6 mmol/L as a diagnostic marker in MASLD and to look into the relationship between clinical outcomes and 1-h PG levels in patients with suspected fatty liver.

The retrospective enrollment was conducted from June 2009 to May 2024 for consecutive participants with imaging evaluations of fatty liver and a 75-g oral glucose tolerance test. Of these, 1154 participants had MASLD, 161 met the diagnostic criteria for nonalcoholic fatty liver disease but not MASLD (NAFLD-non-MASLD), and 1026 subjects had non-fatty liver.

When compared to patients with non-fatty liver, individuals with MASLD or NAFLD-non-MASLD expressed higher 1-h PG levels. The probability of moderate-to-severe steatosis, ALT elevation, advanced fibrosis (p = 0.03), and cardiovascular illnesses was linked to 1-h PG ≥ 8.6 mmol/L in individuals with MASLD or NAFLD-non-MASLD. Also, the frequency of advanced fibrosis was greater in NAFLD-non-MASLD patients with 1-h PG ≥ 8.6 mmol/L than in MASLD patients with or without 1-h PG ≥ 8.6 mmol/L (p < 0.05).

In the patients with NAFLD-non-MASLD, 1-h PG≯≥ 8.6 mmol/L was found to be a risk factor for clinical outcomes such liver fibrosis and CVD. Because 1-h PG levels are predictive of clinical outcomes in individuals with MASLD, the findings suggest that they should be regarded as an independent diagnostic indicator.

Soure:

Teng, L., Luo, L., Sun, Y., Wang, W., Dong, Z., Cao, X., Ye, J., & Zhong, B. (2024). Applying 1-hour postload plasma glucose diagnostic criteria reveals high Progressive Risks of potential MASLD. In Diabetes Research and Clinical Practice (p. 111973). Elsevier BV. https://doi.org/10.1016/j.diabres.2024.111973