Keiko Fuse1, Aya Kadota2, Keiko Kondo3, Katsutaro Morino4, Akira Fujiyoshi5, Takashi Hisamatsu6, Sayaka Kadowaki7, Itsuko Miyazawa8, Satoshi Ugi9, Hiroshi Maegawa10, Katsuyuki Miura11, Hirotsugu Ueshima12. 1. Department of Medicine, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: fusek3@belle.shiga-med.ac.jp. 2. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan; Department of Public Health, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: ayakd@belle.shiga-med.ac.jp. 3. Department of Public Health, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: kon@belle.shiga-med.ac.jp. 4. Department of Medicine, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: morino@belle.shiga-med.ac.jp. 5. Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. Electronic address: afujiy@wakayama-med.ac.jp. 6. Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. Electronic address: hisamatsu@okayama-u.ac.jp. 7. Department of Public Health, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: sayakado@belle.shiga-med.ac.jp. 8. Department of Medicine, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: shimojo@belle.shiga-med.ac.jp. 9. Department of Medicine, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: sugi@belle.shiga-med.ac.jp. 10. Department of Medicine, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: maegawa@belle.shiga-med.ac.jp. 11. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan; Department of Public Health, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: miura@belle.shiga-med.ac.jp. 12. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan; Department of Public Health, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Shiga 520-2192, Japan. Electronic address: hueshima@belle.shiga-med.ac.jp.
Abstract
AIMS: Ectopic fat accumulation is related to insulin resistance and diabetes mellitus (DM). However, the effect of fatty liver on DM in non-obese individuals has not been clarified. We investigated whether liver fat accumulation assessed by computed tomography (CT) is associated with the incidence of DM. METHODS: In a prospective population-based study, 640 Japanese men were followed up for 5 years. The liver to spleen (L/S) ratio of the CT attenuation value was used as the liver fat accumulation index. We calculated the odds ratio (OR) and 95% confidence interval (CI) for the DM incidence of per 1 standard deviation (SD) lower L/S and those of L/S < 1.0 compared with L/S ≥ 1.0, using logistic regression models. RESULTS: Both per 1 SD lower L/S and L/S < 1.0 were significantly associated with a risk for DM incidence (1 SD lower L/S: OR = 1.57, 95%CI = 1.14-2.16; L/S < 1.0: OR = 2.27, 95%CI = 1.00-5.14). The relationship between L/S and incidence of DM was consistent in the obese and non-obese groups, with thresholds of BMI 25 kg/m2, waist circumference 85 cm, or visceral adipose tissue 100 cm2. CONCLUSIONS: Liver fat accumulation assessed by CT was associated with the incidence of DM.
AIMS: Ectopic fat accumulation is related to insulin resistance and diabetes mellitus (DM). However, the effect of fatty liver on DM in non-obese individuals has not been clarified. We investigated whether liver fat accumulation assessed by computed tomography (CT) is associated with the incidence of DM. METHODS: In a prospective population-based study, 640 Japanese men were followed up for 5 years. The liver to spleen (L/S) ratio of the CT attenuation value was used as the liver fat accumulation index. We calculated the odds ratio (OR) and 95% confidence interval (CI) for the DM incidence of per 1 standard deviation (SD) lower L/S and those of L/S < 1.0 compared with L/S ≥ 1.0, using logistic regression models. RESULTS: Both per 1 SD lower L/S and L/S < 1.0 were significantly associated with a risk for DM incidence (1 SD lower L/S: OR = 1.57, 95%CI = 1.14-2.16; L/S < 1.0: OR = 2.27, 95%CI = 1.00-5.14). The relationship between L/S and incidence of DM was consistent in the obese and non-obese groups, with thresholds of BMI 25 kg/m2, waist circumference 85 cm, or visceral adipose tissue 100 cm2. CONCLUSIONS: Liver fat accumulation assessed by CT was associated with the incidence of DM.