ArticlePloS one2021
Fatty liver index as a predictive marker for the development of diabetes: A retrospective cohort study using Japanese health check-up data.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 14 citations in OpenAlex.
- Nonlinear modeling of health checkup factors and future claims-based healthcare costs in Japan: a retrospective cohort study.Health economics review · 2026Article
- Assessment of the Representation of Civil Servants as the General Population in Terms of Health Checkup Data.Cureus · 2025Article
- Dietary Habits and Osteoporotic Fracture Risk: Retrospective Cohort Study Using Large-Scale Claims Data.Journal of the Endocrine Society · 2025Article
- Metabolic dysfunction-associated steatotic liver disease, metabolic alcohol-related liver disease, and incident dementia: a nationwide cohort study : MASLD, MetALD, and dementia risk.BMC gastroenterology · 2025Article
- Pre-diabetes and cardiovascular risk factors in NAFLD patients: a retrospective comparative analysis.Frontiers in endocrinology · 2025Article
- Fatty liver index and risk of type 2 diabetes of adults with normoglycemia: Insights into insulin sensitivity and beta-cell function.PloS one · 2025Article
- The Role of the Fatty Liver Index (FLI) in the Management of Non-Alcoholic Fatty Liver Disease: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- The Link between NAFLD and Metabolic Syndrome.Diagnostics (Basel, Switzerland) · 2023Review
- Nonalcoholic fatty liver disease and diabetes.World journal of diabetes · 2022Review
- Hepatic Steatosis and High-Normal Fasting Glucose as Risk Factors for Incident Prediabetes.Journal of the Endocrine Society · 2022Article
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Authors and funding
3 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsFatty liver is associated with incident diabetes, and the fatty liver index (FLI) is a surrogate marker for non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether or not FLI was associated with incident diabetes in relation to obesity and prediabetic levels in the general Japanese population.
methodsThis was a retrospective study using the Japanese health check-up database of one health insurance from FY2015 to FY2018. This study included 28,991 individuals with prediabetes. First, we stratified all participants into two groups: "high-risk," comprising patients with HbA1c >6.0%, and "standard," comprising the rest. Subsequently, we divided them into four groups according to FLI (<30 or not) and obesity (BMI <25 kg/m2 or not). Subsequently, the incidence rate of diabetes was compared among the groups after 3 years of follow-up using multiple logistic regression models after adjusting for potential confounders.
resultsAfter 3 years of follow-up, 1,547 new cases of diabetes were found, and the cumulative incidence was 2.96% for the standard group and 26.1% for the high-risk group. In non-obese individuals, odds ratios (95% confidence interval) for FLI ≥30 versus FLI <30 were: 1.44 (1.09-1.92) for the standard group and 1.42 (0.99-2.03) for the high-risk group. In the high-risk group, obesity (BMI ≥25 kg/m2) but FLI <30 was not a risk factor for developing diabetes.
conclusionAlthough high FLI is generally considered to be a risk factor for developing diabetes, obesity might have been a confounding factor. However, the present study showed that high FLI is a risk factor for the development of diabetes, even in non-obese individuals. Our results include suggestion to develop a screening tool to effectively identify people at high risk of developing diabetes from the population (especially non-obese prediabetes) who are apparently at low health risk and are unlikely to be targeted for health guidance.
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