Association between nonalcoholic fatty liver disease and increased glucose-to-albumin ratio in adults without diabetes

Shuai Wang; Xiaohong Lin; Chuchen Zhu; Yuqi Dong; Yiwen Guo; Zhonghao Xie; Xiaoshun He; Weiqiang Ju; Maogen Chen

doi:10.3389/fendo.2023.1287916

Association between nonalcoholic fatty liver disease and increased glucose-to-albumin ratio in adults without diabetes

Front Endocrinol (Lausanne). 2024 Jan 8:14:1287916. doi: 10.3389/fendo.2023.1287916. eCollection 2023.

Authors

Shuai Wang^#^{1

2

3}, Xiaohong Lin^#⁴, Chuchen Zhu^#^{1

2

3}, Yuqi Dong^{1

2

3}, Yiwen Guo^{1

2

3}, Zhonghao Xie^{1

2

3}, Xiaoshun He^{1

2

3}, Weiqiang Ju^{1

2

3}, Maogen Chen^{1

2

3}

Affiliations

¹ Organ Transplant Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
² Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China.
³ Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China.
⁴ Department of Breast and Thyroid Surgery, Eastern Hospital of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

^# Contributed equally.

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) affects approximately 30% of individuals globally. Both serum glucose and albumin were demonstrated to be potential markers for the development of NAFLD. We hypothesized that the risk of NAFLD may be proportional to the glucose-to-albumin ratio (GAR).

Methods: Based on information from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, it was determined that GAR was associated with an increased risk of NAFLD and liver fibrosis utilizing weighted multivariable logistic regression. Participants with a fatty liver index (FLI) over 60 were identified with NAFLD, and those with an NAFLD fibrosis score (NFS) >0.676 with evidence of NAFLD were labeled with advanced hepatic fibrosis (AHF). The liver biopsy was utilized to verify the relationship between GAR and FLD in our center cohort. Mendelian randomization analysis investigated the genetic relationship between GAR and NAFLD.

Results: Of 15,534 eligible participants, 36.4% of participants were identified as NAFLD without AHF. GAR was positively correlated with the probability of NAFLD following full adjustment for possible variables (OR = 1.53, 95% CI: 1.39-1.67). It was confirmed that patients with NAFLD and AHF had an inferior prognosis. The relationship between GAR and NFS was favorable (R = 0.46, P< 0.0001), and NAFLD patients with a higher GAR tended to develop poor survival. In our center cohort, the association between GAR and NAFLD was verified.

Conclusion: Among participants without diabetes, greater GAR was linked to higher risks of NAFLD. In addition, NAFLD patients with higher GAR tended to develop liver fibrosis and adverse outcomes.

Keywords: advanced hepatic fibrosis; diabetes; donor liver; glucose-albumin ratio; nonalcoholic fatty liver disease.

Publication types

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

MeSH terms

Adult
Albumins
Diabetes Mellitus*
Glucose
Humans
Liver Cirrhosis
Non-alcoholic Fatty Liver Disease*
Nutrition Surveys

Substances

Albumins
Glucose

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China (81770410), Guangdong Basic and Applied Basic Research Foundation (2020A1515011557, 2020A1515010903), Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology (2020B1212060026), Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation) (2020A0505020003), “Elite program” especially supported by China organ transplantation development foundation (2019JYJH12), China.