Busquets-Cortés, CarlaBennasar-Veny, MiquelLopez-Gonzalez, Angel-ArturoFresneda, SergioAguilo, AntoniYañez, Aina M2024-09-182024-09-182021Busquets-Cortes C, Bennasar-Veny M, Lopez-Gonzalez AA, Fresneda S, Aguilo A, Yanez A. Fatty liver index and progression to type 2 diabetes: a 5-year longitudinal study in Spanish workers with pre-diabetes. BMJ Open. 2021 ;11(8):e045498.2044-6055https://hdl.handle.net/20.500.13003/19598https://hdl.handle.net/20.500.12105/23157Objective: The main aim of the study was to evaluate the association between non-alcoholic fatty liver disease (NAFLD), estimated by fatty liver index (FLI), and the development of type 2 diabetes (T2D) in a large cohort of adult workers with pre-diabetes. Design: Prospective cohort study. Setting Occupational health services from Spain. Participants 16 648 adult workers (aged 20-65 years) with pre-diabetes (fasting plasma glucose (FPG) of 100-125 mg/dL). Outcome and measures FLI was calculated based on measurements of triglycerides, body mass index, waist circumference and gamma-glutamyltransferase. The population was classified into three categories: FLI<30 (no hepatic steatosis), FLI 30-60 (intermediate status) and FLI>60 (hepatic steatosis). Sociodemographic, anthropometric, dietary habits, physical activity and clinical data were collected from all subjects. The incidence rate of T2D was determined after 5 years of follow-up. Results: After 5 years of follow-up, 3706 of the 16 648 participants (22.2%) were diagnosed with T2D, corresponding to an annual rate of progression of 4.5%. FLI was strongly associated with T2D conversion. The incidence rates of T2D in the FLI<30, FLI 30-60 and FLI>60 groups were significantly different after 5 years of follow-up were 19/6,421 (0.3%), 338/4,318 (7.8%) and 3,349/5,909 (56.7%), respectively. This association remained significant for FLI>60 after adjustment for, age, diet, physical activity, FPG, blood pressure, social class and smoking habits (adjusted HR=6.879; 95% CI 5.873 to 8.057 for men, and HR=5.806; 95% CI 4.863 to 6.932 for women). Conclusion: NAFLD assessed by FLI independently predicted the risk of conversion to T2D among people with pre-diabetes. FLI may be an easily determined and valuable early predictor for T2D in people with pre-diabetes. FLI-based assessment of NAFLD in subjects with pre-diabetes in routine clinical practice could allow the adoption of effective measures to prevent and reduce their progression to T2D.enghttp://creativecommons.org/licenses/by/4.0/Diabetes & endocrinologyNutrition & dieteticsPrimary careOccupational & industrial medicineDiabetes Mellitus, Type 2Prediabetic StateMaleProspective StudiesAdultFemaleRisk FactorsHumansNon-alcoholic Fatty Liver DiseaseLongitudinal Studiesresearch articleAttribution 4.0 International34433590118e04549810.1136/bmjopen-2020-045498BMJ Openopen accessFactores de RiesgoEstudios LongitudinalesHumanosEstudios ProspectivosEstado PrediabéticoDiabetes Mellitus Tipo 2FemeninoEnfermedad del Hígado Graso no AlcohólicoAdultoMasculino2-s2.0-85113976343689747400003L635827309