Fatty liver index predicts incident diabetes in a Japanese general population with and without impaired fasting glucose.

AIM: Fatty liver is associated with the development of diabetes. However, to our knowledge, no study has examined the relationship between the fatty liver index (FLI), calculated scores of hepatic steatosis, and the development of diabetes among individuals without impaired fasting glucose (IFG). We aimed to examine whether FLI predicts the development of diabetes in individuals with and without IFG in a Japanese general population. METHODS: We selected 1498 men and 2941 women who participated in Specific Health Checkups in Japan. We divided all participants into six groups according to tertiles of FLI (low, moderate, and high) and the presence or absence of IFG, by sex. We calculated hazard ratios for incident diabetes for each group using a Cox proportional hazard model, adjusting for potential confounders. RESULTS: During a mean follow-up period of 3.0 years, 176 cases of diabetes in men and 320 cases in women were identified. Compared with the low FLI group without IFG, the high FLI group without IFG was significantly associated with incident diabetes in both men (hazard ratio, 1.90; 95% confidence interval, 1.08-3.36) and women (hazard ratio, 1.72; 95% confidence interval, 1.18-2.51). All IFG groups were significantly associated with incident diabetes regardless of FLI levels. CONCLUSIONS: Our results showed that FLI is associated with the development of diabetes regardless of sex and the presence or absence of IFG, and that it may be a useful predictor of future risk of incident diabetes even in individuals without IFG.

Association between lifestyle factors assessed by standard question items of specific health checkup and the incidence of metabolic syndrome and hypertension in community dwellers: A five-year cohort study of National Health Insurance beneficiaries in Habikino City.

Objective　From April 2008, specific health checkups have been implemented to prevent metabolic syndrome (MetS) and related cardiovascular diseases based on assurance of medical care for the elderly in Japan. In its "Standard Health Checkup and Counseling Guidance Program," 22 standard question items are recommended to assess health conditions of Japanese citizens. However, there are few community-based studies to clarify the relationship between question items and new onset of high risk conditions for cardiovascular diseases such as MetS. Accordingly, we performed a 5-year follow-up study of community dwellers who participated in health checkups of National Health Insurance beneficiaries in Habikino City, Osaka.Method　Lifestyle factors assessed by standard question items in 2008 were defined as exposures at baseline survey. In the analysis of MetS, we followed-up 4,720 participants without MetS; and in the analysis of hypertension, we followed-up 3,326 participants without hypertension until the end of March in 2013. New-onset MetS or hypertension during follow-up were defined as outcomes. Cox proportional hazard model was used to evaluate the relationship between lifestyle factors and the incidence of MetS or hypertension after adjustment for age and waist circumference.Results　The median follow-up period for incidence of MetS was 3.1 years for men and 3.6 years for women. We observed 570 new cases of MetS during follow-up. For men, "taking dinner within 2 hours before going to sleep" and "body weight increase by 10 kg or greater from 20 years old" were significantly associated with MetS (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.09-1.88 and HR, 1.33; 95% CI, 1.19-1.75, respectively). Occasional consumption of alcohol in men was negatively associated with MetS. For women, "increase or decrease of body weight by 3 kg or greater within 1 year" and "body weight increase by 10 kg or greater from age of 20" were significantly associated with MetS (HR, 1.83; 95% CI, 1.40-2.40 and HR, 2.02; 95% CI, 1.52-2.68, respectively). Daily alcohol consumption from 1 to less than 2 gou (about 23 to 45 g of ethanol) in women was positively associated with MetS (HR, 2.64; 95% CI, 1.51-4.64). We observed 1,045 new cases of hypertension; however, except for daily alcohol consumption for men, no lifestyle factors were associated with incidence of hypertension.Conclusion　Most standard question items of specific health checkups did not predict new-onset MetS or hypertension, at least within 5 years. Thus, development of more predictive question items is warranted.