Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study

Objective Glucose metabolism status (GMS) is linked to non-alcoholic fatty liver disease (NAFLD). Higher levels of advanced glycation end products (AGEs) are observed in people with type 2 diabetes mellitus (T2DM) and NAFLD. We examined the association between GMS, non-invasive tests and AGEs, with...

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Main Authors: Annemarie Koster, Ger Koek, Geert Robaeys, Otto Bekers, Simone Eussen, Pieter Dagnelie, Bastiaan de Galan, Casper Schalkwijk, Marleen van Greevenbroek, Coen Stehouwer, Leen Heyens, Hanna Kenjic, Steven Meex, Jeroen Kooman, Hans Savelberg, Martien van Dongen
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/11/1/e001466.full
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author Annemarie Koster
Ger Koek
Geert Robaeys
Otto Bekers
Simone Eussen
Pieter Dagnelie
Bastiaan de Galan
Casper Schalkwijk
Marleen van Greevenbroek
Coen Stehouwer
Leen Heyens
Hanna Kenjic
Steven Meex
Jeroen Kooman
Hans Savelberg
Martien van Dongen
author_facet Annemarie Koster
Ger Koek
Geert Robaeys
Otto Bekers
Simone Eussen
Pieter Dagnelie
Bastiaan de Galan
Casper Schalkwijk
Marleen van Greevenbroek
Coen Stehouwer
Leen Heyens
Hanna Kenjic
Steven Meex
Jeroen Kooman
Hans Savelberg
Martien van Dongen
author_sort Annemarie Koster
collection DOAJ
description Objective Glucose metabolism status (GMS) is linked to non-alcoholic fatty liver disease (NAFLD). Higher levels of advanced glycation end products (AGEs) are observed in people with type 2 diabetes mellitus (T2DM) and NAFLD. We examined the association between GMS, non-invasive tests and AGEs, with liver steatosis and fibrosis.Methods Data from The Maastricht Study, a population-based cohort, were analysed. Participants with alcohol overconsumption or missing data were excluded. GMS was determined via an oral glucose tolerance test. AGEs, measured by skin autofluorescence (SAF), were assessed using an AGE Reader. Associations of GMS and SAF with the fibrosis-4 score (FIB-4), Forns index (FI) and fatty liver index (FLI) were investigated using multivariable linear regression, adjusted for sociodemographic, lifestyle and clinical variables.Results 1955 participants (56.6%) were analysed: 598 (30.6%) had T2DM, 264 (13.5%) had pre-diabetes and 1069 (54.7%) had normal glucose metabolism. Pre-diabetes was significantly associated with FLI (standardised regression coefficient (Stβ) 0.396, 95% CI 0.323 to 0.471) and FI (Stβ 0.145, 95% CI 0.059 to 0.232) but not FIB-4. T2DM was significantly associated with FLI (Stβ 0.623, 95% CI 0.552 to 0.694) and FI (Stβ 0.307, 95% CI 0.226 to 0.388) but not FIB-4. SAF was significantly associated with FLI (Stβ 0.083, 95% CI 0.036 to 0.129), FI (Stβ 0.106, 95% CI 0.069 to 0.143) and FIB-4 (Stβ 0.087, 95% CI 0.037 to 0.137).Conclusion The study showed that adverse GMS and higher glycaemia are positively associated with steatosis. FI, but not FIB-4, was related to adverse GMS concerning fibrosis. This study is the first to demonstrate that SAF is positively associated with steatosis and fibrosis.
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spelling doaj-art-7a7f23c84bba40219beae2b2eae8693c2024-12-16T00:15:09ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742024-12-0111110.1136/bmjgast-2024-001466Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht StudyAnnemarie Koster0Ger Koek1Geert Robaeys2Otto Bekers3Simone Eussen4Pieter Dagnelie5Bastiaan de Galan6Casper Schalkwijk7Marleen van Greevenbroek8Coen Stehouwer9Leen Heyens10Hanna Kenjic11Steven Meex12Jeroen Kooman13Hans Savelberg14Martien van Dongen15CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The NetherlandsSchool of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The NetherlandsHasselt University Faculty of Medicine and Life Sciences, Diepenbeek, BelgiumCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsHasselt University Faculty of Medicine and Life Sciences, Diepenbeek, BelgiumSchool of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The NetherlandsCARIM Cardiovascular Research Institute, Maastricht University, Maastricht, The NetherlandsSchool of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The NetherlandsSchool of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The NetherlandsCAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The NetherlandsObjective Glucose metabolism status (GMS) is linked to non-alcoholic fatty liver disease (NAFLD). Higher levels of advanced glycation end products (AGEs) are observed in people with type 2 diabetes mellitus (T2DM) and NAFLD. We examined the association between GMS, non-invasive tests and AGEs, with liver steatosis and fibrosis.Methods Data from The Maastricht Study, a population-based cohort, were analysed. Participants with alcohol overconsumption or missing data were excluded. GMS was determined via an oral glucose tolerance test. AGEs, measured by skin autofluorescence (SAF), were assessed using an AGE Reader. Associations of GMS and SAF with the fibrosis-4 score (FIB-4), Forns index (FI) and fatty liver index (FLI) were investigated using multivariable linear regression, adjusted for sociodemographic, lifestyle and clinical variables.Results 1955 participants (56.6%) were analysed: 598 (30.6%) had T2DM, 264 (13.5%) had pre-diabetes and 1069 (54.7%) had normal glucose metabolism. Pre-diabetes was significantly associated with FLI (standardised regression coefficient (Stβ) 0.396, 95% CI 0.323 to 0.471) and FI (Stβ 0.145, 95% CI 0.059 to 0.232) but not FIB-4. T2DM was significantly associated with FLI (Stβ 0.623, 95% CI 0.552 to 0.694) and FI (Stβ 0.307, 95% CI 0.226 to 0.388) but not FIB-4. SAF was significantly associated with FLI (Stβ 0.083, 95% CI 0.036 to 0.129), FI (Stβ 0.106, 95% CI 0.069 to 0.143) and FIB-4 (Stβ 0.087, 95% CI 0.037 to 0.137).Conclusion The study showed that adverse GMS and higher glycaemia are positively associated with steatosis. FI, but not FIB-4, was related to adverse GMS concerning fibrosis. This study is the first to demonstrate that SAF is positively associated with steatosis and fibrosis.https://bmjopengastro.bmj.com/content/11/1/e001466.full
spellingShingle Annemarie Koster
Ger Koek
Geert Robaeys
Otto Bekers
Simone Eussen
Pieter Dagnelie
Bastiaan de Galan
Casper Schalkwijk
Marleen van Greevenbroek
Coen Stehouwer
Leen Heyens
Hanna Kenjic
Steven Meex
Jeroen Kooman
Hans Savelberg
Martien van Dongen
Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
BMJ Open Gastroenterology
title Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
title_full Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
title_fullStr Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
title_full_unstemmed Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
title_short Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
title_sort forns index and fatty liver index but not fib 4 are associated with indices of glycaemia pre diabetes and type 2 diabetes analysis of the maastricht study
url https://bmjopengastro.bmj.com/content/11/1/e001466.full
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