K Kantartzis1, I Rettig2, H Staiger1, J Machann3, F Schick3, L Scheja4, A Gastaldelli5, E Bugianesi6, A Peter1, M B Schulze7, A Fritsche1, H-U Häring1, N Stefan8. 1. Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller Street 10, 72076 Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases (IDM), Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany. 2. Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller Street 10, 72076 Tübingen, Germany. 3. German Center for Diabetes Research (DZD), Neuherberg, Germany; Section on Experimental Radiology, University of Tübingen, Tübingen, Germany. 4. Department of Biochemistry and Molecular Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 5. Institute of Clinical Physiology National Research Council, Pisa, Italy. 6. Division of Gastroenterology, Department of Medical Sciences, University of Torino, Torino, Italy. 7. German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. 8. Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller Street 10, 72076 Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases (IDM), Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany. Electronic address: norbert.stefan@med.uni-tuebingen.de.
Abstract
BACKGROUND: In clinical practice, there is a strong interest in non-invasive markers of non-alcoholic fatty liver disease (NAFLD). Our hypothesis was that the fold-change in plasma triglycerides (TG) during a 2-h oral glucose tolerance test (fold-change TGOGTT) in concert with blood glucose and lipid parameters, and the rs738409 C>G single nucleotide polymorphism (SNP) in PNPLA3 might improve the power of the widely used fatty liver index (FLI) to predict NAFLD. METHODS: The liver fat content of 330 subjects was quantified by 1H-magnetic resonance spectroscopy. Blood parameters were measured during fasting and after a 2-h OGTT. A subgroup of 213 subjects underwent these measurements before and after 9 months of a lifestyle intervention. RESULTS: The fold-change TGOGTT was closely associated with liver fat content (r=0.51, P<0.0001), but had less power to predict NAFLD (AUROC=0.75) than the FLI (AUROC=0.79). Not only was the fold-change TGOGTT independently associated with liver fat content and NAFLD, but so also were the 2-h blood glucose level and rs738409 C>G SNP in PNPLA3. In fact, a novel index (extended FLI) generated from these and the usual FLI parameters considerably increased its power to predict NAFLD (AUROC=0.79-0.86). The extended FLI also increased the power to predict changes in liver fat content with a lifestyle intervention (n=213; standardized beta coefficient: 0.23-0.29). CONCLUSION: This study has provided novel data confirming that the OGTT-derived fold-change TGOGTT and 2-h glucose level, together with the rs738409 C>G SNP in PNPLA3, allow calculation of an extended FLI that considerably improves its power to predict NAFLD.
BACKGROUND: In clinical practice, there is a strong interest in non-invasive markers of non-alcoholic fatty liver disease (NAFLD). Our hypothesis was that the fold-change in plasma triglycerides (TG) during a 2-h oral glucose tolerance test (fold-change TGOGTT) in concert with blood glucose and lipid parameters, and the rs738409 C>G single nucleotide polymorphism (SNP) in PNPLA3 might improve the power of the widely used fatty liver index (FLI) to predict NAFLD. METHODS: The liver fat content of 330 subjects was quantified by 1H-magnetic resonance spectroscopy. Blood parameters were measured during fasting and after a 2-h OGTT. A subgroup of 213 subjects underwent these measurements before and after 9 months of a lifestyle intervention. RESULTS: The fold-change TGOGTT was closely associated with liver fat content (r=0.51, P<0.0001), but had less power to predict NAFLD (AUROC=0.75) than the FLI (AUROC=0.79). Not only was the fold-change TGOGTT independently associated with liver fat content and NAFLD, but so also were the 2-h blood glucose level and rs738409 C>G SNP in PNPLA3. In fact, a novel index (extended FLI) generated from these and the usual FLI parameters considerably increased its power to predict NAFLD (AUROC=0.79-0.86). The extended FLI also increased the power to predict changes in liver fat content with a lifestyle intervention (n=213; standardized beta coefficient: 0.23-0.29). CONCLUSION: This study has provided novel data confirming that the OGTT-derived fold-change TGOGTT and 2-h glucose level, together with the rs738409 C>G SNP in PNPLA3, allow calculation of an extended FLI that considerably improves its power to predict NAFLD.
Authors: Laura Di Renzo; Giulia Cinelli; Maria Dri; Paola Gualtieri; Alda Attinà; Claudia Leggeri; Giuseppe Cenname; Ernesto Esposito; Alberto Pujia; Gaetano Chiricolo; Chiara Salimei; Antonino De Lorenzo Journal: Nutrients Date: 2020-11-11 Impact factor: 5.717
Authors: Stefan Kabisch; Sabrina Bäther; Ulrike Dambeck; Margrit Kemper; Christiana Gerbracht; Caroline Honsek; Anna Sachno; Andreas F H Pfeiffer Journal: Nutrients Date: 2018-01-31 Impact factor: 5.717