Fasting plasma glucose variability linked to NAFLD risk

Individuals with increased long-term fasting plasma glucose (FPG) variability are at heightened risk of developing nonalcoholic fatty liver disease (NAFLD), as suggested in a study.

The study used data from the Korean National Health Insurance System cohort and included 57,636 Korean men and women without NAFLD and diabetes mellitus at baseline. Calculations for FPG variability included the coefficient of variation (FPG-CV), standard deviation (FPG-SD), variability independent of the mean (FPG-VIM), and average successive variability (FPG-ASV).

The Kaplan-Meier curve for cumulative incidence of NAFLD showed progressively increasing trends that corresponded to the higher quartiles of FPG variability.

In a multivariable Cox proportional hazard model, the highest vs lowest quartile of FPG-CV was associated with a 15-percent increase in the risk of incident NAFLD (hazard ratio [HR], 1.15, 95 percent confidence interval [CI], 1.06–1.24). This analysis was controlled for various confounding factors, including mean FPG levels.

Results were similar in analyses that used FPG-SD, FPG-VIM, and FPG-ASV to calculate FPG variability.

A 10-unit increase in FPG variability conferred an increase of 14 percent in the risk of NAFLD in the fully adjusted model. This effect persisted in subgroup and sensitivity analyses.

The findings confirm that long-term variability in FPG levels may have an adverse impact on the risk of NAFLD that is independent of confounding risk variables, including mean FPG levels, among individuals without diabetes.