Adolescent NAFLD ups T2D risk in young adulthood

Nonalcoholic fatty liver disease (NAFLD) among normoglycaemic adolescents appears to increase the risk of type 2 diabetes (T2D), which may manifest before age 30 years, suggests a recent study.

This nationwide, population-based study assessed the risk of T2D among Israeli adolescents who were examined before military service during 1997–2011 and were followed until 31 December 2016. A total of 1,025,796 normoglycaemic adolescents were included. The investigators used biopsy or radiographic tests to diagnose NAFLD. Data were linked to the Israeli National Diabetes Registry.

Of the 633 adolescents with NAFLD, 12 (1.9 percent; all with high body mass index [BMI] at baseline) had a diagnosis of T2D during a mean follow-up of 13.3 years compared with 2,917 (0.3 percent) adolescents without NAFLD.

After adjusting for BMI and sociodemographic confounders, the NAFLD group showed a hazard ratio [HR] of 2.59 (95 percent confidence interval [CI], 1.47–4.58) for T2D compared with the non-NAFLD group. The increased risk persisted in several sensitivity analyses, including that of individuals without other metabolic comorbidities (adjusted HR, 2.75, 95 percent CI, 1.48–5.14) and of those with high BMI, and an analysis whose outcome was T2D by age 30 years (adjusted HR, 2.14, 95 percent CI, 1.02–4.52).

The significant association persisted when a sex-, birth year-, and BMI-matched control group was used as reference (adjusted HR, 2.98, 95 percent CI, 1.54–5.74).