Association between intrahepatic triglyceride content in subjects with metabolically healthy abdominal obesity and risks of pre-diabetes plus diabetes: an observational study

Qiaoyan Xu; Junfeng Zhang; Haiwei Han; Ning Chen; Fangfang Lai; Yongwen Liu; Caoxin Huang; Mingzhu Lin; Wei Zhang; Shunqin Wang; Changqin Liu; Zhibin Li

doi:10.1136/bmjopen-2021-057820

Association between intrahepatic triglyceride content in subjects with metabolically healthy abdominal obesity and risks of pre-diabetes plus diabetes: an observational study

BMJ Open. 2022 Feb 21;12(2):e057820. doi: 10.1136/bmjopen-2021-057820.

Authors

Qiaoyan Xu^#¹, Junfeng Zhang^#¹, Haiwei Han^#², Ning Chen^#³, Fangfang Lai¹, Yongwen Liu⁴, Caoxin Huang⁵, Mingzhu Lin⁶, Wei Zhang⁷, Shunqin Wang⁸, Changqin Liu^{9

10}, Zhibin Li¹¹

Affiliations

¹ Lianqian Community Health Service Center, The First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China.
² Department of Radiology, The First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China.
³ Department of Endocrinology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.
⁴ Department of Nursing, the First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China.
⁵ Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China.
⁶ Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China.
⁷ Xiamen Institute of Cardiovascular Diseases, the First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China.
⁸ Key laboratory of Neonatal Diseases, Children's Hospital of Fudan University Xiamen Branch & Xiamen Children's Hospital, Xiamen, China.
⁹ Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China liuchangqin@xmu.edu.cn zhibinli33@hotmail.com.
¹⁰ Fujian Province Key Laboratory of Diabetes Translational Medicine, the First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China.
¹¹ Epidemiology Research Unit, Translational Medicine Research Center, the First Affiliated Hospital of Xiamen University, School of medicine, Xiamen university, Xiamen, China liuchangqin@xmu.edu.cn zhibinli33@hotmail.com.

^# Contributed equally.

Abstract

Objective: We aimed to evaluate the association of intrahepatic triglyceride (IHTG) content in subjects with metabolically healthy abdominal obesity (MHAO) on risks of pre-diabetes plus diabetes.

Design: Cross-sectional survey.

Setting: Lianqian community, the First Affiliated Hospital of Xiamen University, Xiamen, China.

Participants: Among 1523 community-living healthy adults aged 40 years or older with abdominal obesity recruited at baseline, 428 subjects who underwent IHTG content measurement were selected.

Outcome measures: Risk of pre-diabetes plus diabetes.

Results: Non-alcoholic fatty liver disease (NAFLD) was diagnosed as 203 (69.1%) in MHAO and 121 (90.3%) in metabolically unhealthy abdominal obesity (MUAO) (p<0.001). The prevalence rates of pre-diabetes plus diabetes were 81.1%, 88.8% and 90.9% across the tertiles of IHTG content (p=0.037). Both MUAO (vs MHAO) and NAFLD (vs non-NAFLD) were independently associated with increased risks of pre-diabetes plus diabetes, the adjusted ORs (95% CIs) were 10.90 (3.15 to 37.69, p<0.001) and 3.02 (1.47 to 6.20, p=0.003), respectively. Higher IHTG content was significantly associated with increased risk of pre-diabetes plus diabetes with the adjusted OR (95% CI) of per SD increase of IHTG content of 1.62 (1.07 to 2.46, p=0.024). And there was a significantly positive trend between increasing categories of IHTG content tertiles and excessive risks of pre-diabetes plus diabetes (trend test p value=0.011). Stratified analyses showed similar results on the associations of NAFLD and IHTG content with risks of pre-diabetes plus diabetes for subjects with MHAO but not for those with MUAO.

Conclusions: NAFLD and higher IHTG content were independently associated with increased risks of pre-diabetes plus diabetes in MHAO subjects. NAFLD or quantity of liver fat should be considered as additional criterion when defining and diagnosing MHO. Screening of NAFLD and intervention to reduce liver fat should be strengthened even for those seemly metabolically healthy obese.

Keywords: adult gastroenterology; general diabetes; hepatology.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Humans
Liver
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / epidemiology
Obesity / complications
Obesity, Abdominal / complications
Obesity, Abdominal / epidemiology
Obesity, Metabolically Benign* / complications
Prediabetic State* / complications
Prediabetic State* / epidemiology
Triglycerides

Substances

Triglycerides