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Original Article
- Metabolic Risk/Epidemiology
- Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease
- Teruki Miyake, Shinya Furukawa, Bunzo Matsuura, Osamu Yoshida, Masumi Miyazaki, Akihito Shiomi, Ayumi Kanamoto, Hironobu Nakaguchi, Yoshiko Nakamura, Yusuke Imai, Mitsuhito Koizumi, Takao Watanabe, Yasunori Yamamoto, Yohei Koizumi, Yoshio Tokumoto, Masashi Hirooka, Teru Kumagi, Eiji Takesita, Yoshio Ikeda, Masanori Abe, Yoichi Hiasa
- Diabetes Metab J. 2024;48(3):440-448. Published online February 2, 2024
- DOI: https://doi.org/10.4093/dmj.2023.0200
- 7,850 View
- 329 Download
- 7 Web of Science
- 7 Crossref
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Abstract
PDF
Supplementary Material
PubReader 
ePub - Background
Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.
Methods
This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%.
Results
Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.
Conclusion
Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression. -
Citations
Citations to this article as recorded by
- Association of nitrogen dioxide with non-alcoholic fatty liver disease in Chinese rural older adults: The mediating role of fasting plasma glucose
Yuantao Zhang, Xianglong Liu, Yunkai Hu, Xuqiu Cheng, Wenyuan Liu, Ziwei Tian, Yan Zhang, Guimei Chen, Bing Hu, Changliu Liang, Chunmei Liang, Fangbiao Tao, Linsheng Yang
Environmental Research.2026; 290: 123518. CrossRef - The association between glycemic state, R factor and Steatosis-Associated Fibrosis Estimator score in advanced liver fibrosis in patients with diabetes mellitus
Mohammadjavad Sotoudeheian, Seyed-Mohamad-Sadegh Mirahmadi, Reza Azarbad
Obesity Medicine.2025; 53: 100575. CrossRef - Association of chronic kidney disease and type 2 diabetes mellitus with metabolic dysfunction-associated steatotic liver disease and liver fibrosis assessed by transient elastography: a cross-sectional study based on NHANES 2017–2020
Ting Xu, Weifang Zhu
Diabetes Research and Clinical Practice.2025; 227: 112418. CrossRef - Effect of remnant cholesterol on the onset of diabetes mellitus
Teruki Miyake, Shinya Furukawa, Ayumi Kanamoto, Osamu Yoshida, Yoshimasa Murakami, Masumi Miyazaki, Akihito Shiomi, Sho Ishikawa, Yuki Numata, Hironobu Nakaguchi, Yoshiko Nakamura, Mitsuhito Koizumi, Takao Watanabe, Yasunori Yamamoto, Hirohito Mori, Eiji
Journal of Diabetes Investigation.2025;[Epub] CrossRef - Efficacy and Safety of GLP-1 Receptor Agonists in MASH with Fibrosis: A Systematic Review and Meta-Analysis
Rafael Dos Santos Borges, Eliabe S. Abreu, Giovanni Gosch Berton, Luiza Haikal de Paula, Ana Flávia Conegundes, Jefferson Manoel Borges Martins, Marcelo Albuquerque Barbosa Martins, Aladdin S. Dahbour, Matheus Vanzin Fernandes, Manal F. Abdelmalek
JHEP Reports.2025; : 101708. CrossRef - Combined effect of histological findings and diabetes mellitus on liver‐related events in patients with metabolic dysfunction‐associated steatotic liver disease
Akihito Shiomi, Teruki Miyake, Shinya Furukawa, Bunzo Matsuura, Osamu Yoshida, Takao Watanabe, Ayumi Kanamoto, Masumi Miyazaki, Hironobu Nakaguchi, Yoshio Tokumoto, Masashi Hirooka, Masanori Abe, Yoichi Hiasa
Hepatology Research.2024; 54(11): 1016. CrossRef - Overweight Impacts Histological Disease Activity of De Novo Metabolic Dysfunction‐Associated Steatotic Liver Disease After Liver Transplantation
Alejandro Campos‐Murguia, Lea Guetzlaff, Emily Bosselmann, Bastian Engel, Björn Hartleben, Heiner Wedemeyer, Elmar Jaeckel, Richard Taubert, Katharina Luise Hupa‐Breier
Clinical Transplantation.2024;[Epub] CrossRef
- Association of nitrogen dioxide with non-alcoholic fatty liver disease in Chinese rural older adults: The mediating role of fasting plasma glucose
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