Fatty liver index and risk of diabetes incidence: A systematic review and dose-response meta-analysis of cohort studies

Mina Movahedian; Jamal Rahmani; Seyed Saeed Hashemi Nazari; Susan Mohamadi; Gurudatta Naik; Azita Hekmatdoost

doi:10.1016/j.pcd.2020.02.011

Fatty liver index and risk of diabetes incidence: A systematic review and dose-response meta-analysis of cohort studies

Prim Care Diabetes. 2020 Dec;14(6):577-583. doi: 10.1016/j.pcd.2020.02.011. Epub 2020 Jul 18.

Authors

Mina Movahedian¹, Jamal Rahmani², Seyed Saeed Hashemi Nazari³, Susan Mohamadi¹, Gurudatta Naik⁴, Azita Hekmatdoost⁵

Affiliations

¹ Department of Clinical Nutrition and Dietetics, Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham AL, United States.
⁵ Department of Clinical Nutrition and Dietetics, Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: azita.hekmatdoost@sbmu.ac.ir.

PMID: 32694004
DOI: 10.1016/j.pcd.2020.02.011

Abstract

Aims: Fatty Liver Index (FLI) is a surrogate index for diagnosis of Fatty Liver Disease (FLD). We performed a dose-response meta-analysis to investigate the relationship between FLI and diabetes incidence in prospective cohort studies.

Methods: We conducted a systematic search of articles up to November 2019 in PubMed, SCOPUS, Cochrane library, and Embase. Hazard Ratios (HRs) with corresponding 95% confidence intervals (CIs) of studies were pooled using meta-analysis with DerSimonian and Laird random-effects models to find combined HRs. Dose-response effect of this relationship was also assessed.

Results: Twenty-seven studies providing 70,918 participants were included in the meta-analysis. Pooled results showed that the highest category of FLI was associated with an increased incidence of diabetes [HR: 2.88, 95% CI: 2.18-3.81; P for heterogeneity: 0.001]. Subgroup analysis based on sex, continent, and the quality of study could not explain the source of heterogeneity. The pooled HR from the random-effects dose-response model indicated a significant association between FLI level and risk of diabetes incidence (Coef=0.0239, p=0.001).

Conclusion: Our dose-response meta-analysis revealed a direct relationship between FLI and HR of diabetes incidence.

Keywords: Diabetes; Dose-response; FLD; FLI; Fatty liver.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Cohort Studies
Diabetes Complications
Diabetes Mellitus* / diagnosis
Diabetes Mellitus* / epidemiology
Fatty Liver* / etiology
Humans
Prospective Studies
Risk Factors