Liver steatosis as a predictor of incident diabetes in adults: a prospective evaluation in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

• Autor(a) principal: Costa Faria, Luciana
• Data de Publicação: 2023
• Outros Autores: de Fátima Haueisen Sander Diniz, Maria, Giatti, Luana, Inês Schmidt, Maria, carvalho goulart, alessandra, Bartholow Duncan, Bruce, Maria Barreto, Sandhi
• 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/8262
• topic: Esteatose Hepática; Hepatopatia Gordurosa não Alcoólica; Diabetes Mellitus Tipo 2; Resistência à Insulina; Obesidade; Hígado Graso; Enfermedad del Hígado Graso no Alcohólico; Diabetes Mellitus Tipo 2; Resistencia a la Insulina; Obesidad; Liver Steatosis; Non-alcoholic Fatty Liver Disease; Type 2 Diabetes Mellitus; Insulin Resistance; Obesity

Increasing epidemiological evidence suggests a bidirectional relationship between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes, and that NAFLD may precede and/or promote the development of diabetes. This study aimed to investigate whether liver steatosis is associated with the incidence of diabetes in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The ELSA-Brasil is an occupational cohort study of active or retired civil servants, aged 35-74 years, in six capital cities in Brazil. We excluded participants with diabetes at baseline, those who reported excessive alcohol consumption or with missing information on relevant covariates, and those with self-referred hepatitis or cirrhosis. In total, 8,166 individuals participated, and the mean duration of follow-up was 3.8 years. The Cox proportional regression model was used to estimate the adjusted hazard ratio (HR) for the associations. Abdominal ultrasonography was used to detect liver steatosis. In the follow-up period, the cumulative incidence of diabetes was 5.25% in the whole sample, 7.83% and 3.88% in the groups with and without hepatic steatosis, respectively (p < 0.001). Compared to those without steatosis, individuals with hepatic steatosis had an increased risk of developing diabetes (HR = 1.31; 95%CI: 1.09-1.56) after adjustment for potential confounders, including body mass index (BMI). Hepatic steatosis was an independent predictor of incident diabetes in the ELSA-Brasil cohort study. Physicians should encourage changes in lifestyle and screen for diabetes in patients with fatty liver.