Comparing diabetes prediction based on metabolic dysfunction-associated steatotic liver disease and nonalcoholic fatty liver disease: the ELSA-Brasil study

• Autor(a) principal: Wünsch Lopes, Gabriela
• Data de Publicação: 2024
• Outros Autores: Leite Canhada, Scheine, Citton Padilha dos Reis, Rodrigo, de Fátima Haueisen Sander Diniz, Maria, Carvalho Goulart, Alessandra, Costa Faria, Luciana, Harter Griep, Rosane, Perazzo, Hugo, Bartholow Duncan, Bruce, Inês Schmidt, Maria
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Cadernos de Saúde Pública
• Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8743
• topic: Hepatopatia Gordurosa não Alcoólica; Diabetes Mellitus Tipo 2; Etnicidade; Enfermedad del Hígado Graso no Alcohólico; Diabetes Mellitus Tipo 2; Etnicidad; Non-Alcoholic Fatty Liver Disease; Type 2 Diabetes Mellitus; Ethnicity

We aimed to compare nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) definitions concerning diabetes prediction in a large sample of Brazilian adults. As a secondary objective, we compared associations between NAFLD/MASLD and diabetes across self-declared race/skin color groups. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study of Brazilian civil servants (35-74 years) enrolled from 2008 to 2010 and followed up from 2012-2014 and 2017-2019. We ascertained type 2 diabetes mellitus at baseline as well as follow-up visits based on self-reported diagnosis, medication use, and glycemic tests (fasting and 2h post-OGTT glucose and HbA1c). We excluded individuals with heavy alcohol consumption or self-reported cirrhosis/hepatitis. We analyzed 7,073 subjects. NAFLD was defined by ultrasound-based steatosis. Participants with steatosis and at least one cardiometabolic factor were considered as having MASLD. Cox proportional hazards models were performed to evaluate the association between NAFLD/MASLD and the incidence of type 2 diabetes mellitus. At baseline, 33.9% of individuals presented NAFLD and 32.5% presented MASLD. Over 9.4 years of follow-up, the relative increase in the incidence of diabetes was 78% for NAFLD (HR = 1.78; 95%CI: 1.58-2.01) and 88% for MASLD (HR = 1.88; 95%CI: 1.67-2.12). Associations did not differ significantly among race/skin color groups (p for interaction = 0.10 for MASLD and 0.08 for NAFLD). In this large cohort of middle-aged and older Brazilian adults, the relative incidence of diabetes was similar for NAFLD and MASLD definitions, with similar associations in all ethnic groups.