A cohort study of fatty liver index in predicting the risk of developing type 2 diabetes mellitus.

Objective To investigate the role of fatty liver index (FLI) in predicting the risk of developing type 2 diabetes mellitus(T2DM). Methods This study was a retrospective cohort study. A number of 1 398 participants from a medical examination center of PLA Rocket Force Characteristic Medical Center from June 2013 to September 2020 were enrolled. The participants were equal or more than 40 years old and without previous T2DM. The general information, physical examination data and laboratory indexes were analyzed, and the occurrence of T2DM was followed up as the research outcome indicator. According to the FLI levels at baseline, the research subjects were divided into FLI<30 group (824 cases), 30≤FLI<60 group (420 cases), and FLI≥60 group (154 cases). The t test and analysis of variance (ANOVA) were used to compare the means of two or more groups of a categorical variable, and chi-square test was used for testing relationships on categorical variables. Non-parametric test (wilcoxon rank sum test) was used when the continuous variables were not distributed normally. Multivariate Cox regression analysis was used to assess the risk of T2DM in the FLI group with different fasting glucose status at baseline. Results The average follow-up time of the study was 5.7 years. During the follow-up period, a total of 240 people (17.17%) were diagnosed with T2DM. Compared with those without T2DM group (1 158 cases), individuals with T2DM were older and had higher waist circumference, body mass index, systolic blood pressure, fasting blood glucose, oral glucose tolerance test 2-hours plasma glucose and FLI levels (P<0.05). Participants with a family history of diabetes were more likely to develop T2DM (P< 0.01). After adjusting for baseline age, gender, smoking, drinking, exercise and family history of diabetes, among the participants with normal fasting glucose at baseline, compared with the population with FLI<30 group, the participants who with 30≤FLI<60 group (HR=1.18, 95%CI 0.84-1.64, P>0.05) and FLI≥60 group (HR=1.57, 95%CI 1.01-2.44, P<0.05) had higher risk of developing T2DM. Among the participants with impaired fasting glucose at baseline, compared with the FLI<30 group, participants with 30≤FLI<60 group (HR=1.19, 95%CI 0.44-3.20) and FLI≥60 group (HR=1.32, 95%CI 0.44-3.94) had higher risk of developing T2DM, but the difference was not statistically significant (P>0.05). Conclusion In a certain department of physical examination center, without impaired fasting glucose, high FLI has predictive value for the risk of T2DM. [ABSTRACT FROM AUTHOR]