ArticleBMJ open2021
Fatty liver index and progression to type 2 diabetes: a 5-year longitudinal study in Spanish workers with pre-diabetes.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors for progression to type 2 diabetes in prediabetes: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Bidirectional relationship between metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus.EXCLI journal · 2026Review
- Article
- Fatty liver index and risk of type 2 diabetes of adults with normoglycemia: Insights into insulin sensitivity and beta-cell function.PloS one · 2025Article
- Risk Factors for the Progression or Regression to Diabetes or Normoglycaemia for Men with Impaired Fasting Glucose.Journal of diabetes research · 2025Article
- Mortality and risk of diabetes, liver disease, and heart disease in individuals with haemochromatosisBMJ (Clinical research ed.) · 2024Article
- The Role of the Fatty Liver Index (FLI) in the Management of Non-Alcoholic Fatty Liver Disease: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- Serum Mac-2 Binding Protein Glycosylation Isomer Concentrations Are Associated With Incidence of Type 2 Diabetes.The Journal of clinical endocrinology and metabolism · 2023Article
- Article
- Association of Fatty Liver Index with Incident Diabetes Risk in Patients Initiating Statin-Therapy: A 6-Year Retrospective Study.Diagnostics (Basel, Switzerland) · 2023Article
- Development and application of a novel model to predict the risk of non-alcoholic fatty liver disease among lean pre-diabetics with normal blood lipid levels.Lipids in health and disease · 2022Article
- Relationship between Insulin Resistance Risk Scales and Non-Alcoholic Fatty Liver Disease and Liver Fibrosis Scales in 219,477 Spanish Workers.Metabolites · 2022Article
- Sex and age differences in the association of fatty liver index-defined non-alcoholic fatty liver disease with cardiometabolic risk factors: a cross-sectional study.Biology of sex differences · 2022Article
- Liver Fetuin-A at Initiation of Insulin Resistance.Metabolites · 2022Article
- Fatty liver index as a predictor for incident type 2 diabetes in community-dwelling adults: longitudinal findings over 12 years.Cardiovascular diabetology · 2022Article
- Identifying risk factors of developing type 2 diabetes from an adult population with initial prediabetes using a Bayesian network.Frontiers in public health · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe main aim of the study was to evaluate the association between non-alcoholic fatty liver disease (NAFLD), estimated by fatty liver index (FLI), and the development of type 2 diabetes (T2D) in a large cohort of adult workers with pre-diabetes.
designProspective cohort study.
settingOccupational health services from Spain.
participants16 648 adult workers (aged 20-65 years) with pre-diabetes (fasting plasma glucose (FPG) of 100-125 mg/dL). OUTCOME AND MEASURES: FLI was calculated based on measurements of triglycerides, body mass index, waist circumference and γ-glutamyltransferase. The population was classified into three categories: FLI<30 (no hepatic steatosis), FLI 30-60 (intermediate status) and FLI>60 (hepatic steatosis). Sociodemographic, anthropometric, dietary habits, physical activity and clinical data were collected from all subjects. The incidence rate of T2D was determined after 5 years of follow-up.
resultsAfter 5 years of follow-up, 3706 of the 16 648 participants (22.2%) were diagnosed with T2D, corresponding to an annual rate of progression of 4.5%. FLI was strongly associated with T2D conversion. The incidence rates of T2D in the FLI<30, FLI 30-60 and FLI>60 groups were significantly different after 5 years of follow-up were 19/6,421 (0.3%), 338/4,318 (7.8%) and 3,349/5,909 (56.7%), respectively. This association remained significant for FLI>60 after adjustment for, age, diet, physical activity, FPG, blood pressure, social class and smoking habits (adjusted HR=6.879; 95% CI 5.873 to 8.057 for men, and HR=5.806; 95% CI 4.863 to 6.932 for women).
conclusionNAFLD assessed by FLI independently predicted the risk of conversion to T2D among people with pre-diabetes. FLI may be an easily determined and valuable early predictor for T2D in people with pre-diabetes. FLI-based assessment of NAFLD in subjects with pre-diabetes in routine clinical practice could allow the adoption of effective measures to prevent and reduce their progression to T2D.
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