Skip to main content
Log in

Nonalcoholic fatty liver is a risk factor for postprandial hyperglycemia, but not for impaired fasting glucose

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Purpose

The first aim of this study was to elucidate the relationship between impaired glucose tolerance (IGT) and nonalcoholic fatty liver. The second was to make a rule regarding to whom 75-g oral glucose tolerance tests (OGTTs) should be applied to identify subjects with IGT and diabetes mellitus (DM) in the annual check-up at the human dry dock.

Methods

A total of 716 subjects who visited the Department of General Medicine of the International Medical Center of Japan from May 2001 through January 2008 for an annual check-up at the human dry dock were analyzed. We evaluated risk factors related to nonalcoholic fatty liver using multivariate logistic regression analysis and compared the difference of body mass index (BMI) and glucose level at 75-g OGTT at two different time points in subjects whose fatty change had improved or worsened.

Results

Nonalcoholic fatty liver was strongly related to 2-h- and 1-h-post-challenge glucose level (P < 0.0001 and P = 0.018, respectively), but not fasting plasma glucose (FPG) (P = 0.706). The risk factors for IGT were nonalcoholic fatty liver (P < 0.05), low levels of high-density lipoprotein cholesterol (HDL-C) (P = 0.026) and age (P = 0.013). A clearly positive relationship was observed between the difference of BMI and 2-h-post-challenge glucose level among the subjects whose fatty change had improved or worsened (R = 0.6, P = 0.018).

Conclusions

Nonalcoholic fatty liver was clearly related to the 2-h- or 1-h-post-challenge glucose level, but not to FPG, in 75-g OGTT, and this IGT was corrected by body weight reduction in accordance with diminished nonalcoholic fatty liver. Thus, 75-g OGTT should be applied to subjects with nonalcoholic fatty liver to evaluate IGT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullogh AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology. 1999;116:413–1419.

    Article  Google Scholar 

  2. Teli MR, James OF, Burt AD, Bennett MK, Day CP. The natural history of nonalcoholic fatty liver: a follow-up study. Hepatology. 1995;22:1714–9.

    Article  PubMed  CAS  Google Scholar 

  3. Su C-C, Wang K, Hsia T-L, Chen C-S, Tung T-H. Association of nonalcoholic fatty liver disease with abnormal aminotransferase and postprandial hyperglycemia. J Clin Gastroenterol. 2006;40:551–4.

    Article  PubMed  CAS  Google Scholar 

  4. Day CP, James O. Steatohepatitis: a tale of “two-hits”. Gastroenterology. 1998;114:842–5.

    Article  PubMed  CAS  Google Scholar 

  5. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346:1221–31.

    Article  PubMed  CAS  Google Scholar 

  6. Sargin M, Uygur-Bayramiçli O, Sargin H, Orbay E, Yayla A. Association of nonalcoholic fatty liver disease with insulin resistance. Is OGTT indicated in nonalcoholic fatty liver disease? J Clin Gastroenterol. 2003;37:399–402.

    Article  PubMed  CAS  Google Scholar 

  7. Frilis-Liby I, Aldenborg F, Jerlstad P, Rundström K, Björnsson E. High prevalence of metabolic complications in patients with non-alcoholic fatty liver disease. Scand J Gastroenterol. 2004;9:864–9.

    Article  CAS  Google Scholar 

  8. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979;28:1039–57.

    Google Scholar 

  9. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20:1183–97.

    Google Scholar 

  10. Alberti KGMM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation. Diabet Med. 1998;15:539–53. for the WHO Consultation.

    Article  PubMed  CAS  Google Scholar 

  11. Kuzuya T, Nakagawa S, Satoh J, Kanazawa Y, Iwamoto Y, Kobayashi M, et al. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. Diabetes Res Clin Pract. 2002;55:65–85.

    Article  PubMed  Google Scholar 

  12. Kawamori R. The role of the liver on post-prandial glycaemia-emphasis on hepatic glucose uptake. Int J Clin Prat Suppl. 2000;112:19–22.

    CAS  Google Scholar 

  13. Mueller MJ, Boeker K, Selberg O. Metabolism of energy yielding substrates in patients with liver cirrhosis. Clin Invest. 1994;72:568–79.

    CAS  Google Scholar 

  14. Owen OE, Trapp VE, Rechard GA, et al. Nature and quantity of fuels consumed in patients with alcoholic cirrhosis. J Clin Invest. 1983;72:1821–32.

    Article  PubMed  CAS  Google Scholar 

  15. Verboeket-van de Venne WP, Weserterp KR, van Hoek B, Swart GR. Energy expenditure and substrate metabolism in patients with cirrhosis of the liver: effects of the pattern of food intake. Gut. 1995;36:110–6.

    Article  PubMed  CAS  Google Scholar 

  16. Imano E, Kanda T, Nakatani Y, et al. Impaired splanchnic and peripheral glucose uptake in liver cirrhosis. J Hepatol. 1999;31:469–73.

    Article  PubMed  CAS  Google Scholar 

  17. Kruszynska YT, Home PD, McIntyre N. Relationship between insulin sensitivity, insulin secretion and glucose tolerance in cirrhosis. Hepatology. 1991;14:103–11.

    Article  PubMed  CAS  Google Scholar 

  18. Shmueli E, Walker M, Alberti G, Record CO. Normal splanchnic but impaired peripheral insulin-stimulated glucose uptake in cirrhosis. Hepatology. 1993;18:86–95.

    Article  PubMed  CAS  Google Scholar 

  19. Leatherdale BA, Chase RA, Rogers J, Alberti KG, Davies P, Record CO. Forearm glucose uptake in cirrhosis and its relationship to glucose tolerance. Clin Sci. 1980;59:191–8.

    PubMed  CAS  Google Scholar 

  20. Selberg O, Burchert W, vd Hoff J, Meyer GJ, Hundeshagen H, Radoch E, et al. Insulin resistance in liver cirrhosis. J Clin Invest. 1993;91:1897–902.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

We thank Dr. Satoru Shimizu (Medical Research Institute, Tokyo Women’s Medical University) for his assistance with the statistical analysis.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hikaru Nagahara.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shiga, T., Moriyoshi, Y., Nagahara, H. et al. Nonalcoholic fatty liver is a risk factor for postprandial hyperglycemia, but not for impaired fasting glucose. J Gastroenterol 44, 757–764 (2009). https://doi.org/10.1007/s00535-009-0059-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-009-0059-1

Keywords

Navigation