PMID- 24223115
OWN - NLM
STAT- MEDLINE
DCOM- 20140820
LR  - 20221207
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 11
DP  - 2013
TI  - Glycemic variability is an independent predictive factor for development of 
      hepatic fibrosis in nonalcoholic fatty liver disease.
PG  - e76161
LID - 10.1371/journal.pone.0076161 [doi]
LID - e76161
AB  - Patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic 
      steatohepatitis (NASH) often have metabolic disorders including insulin 
      resistance and type 2 diabetes mellitus (T2DM). We clarified the predictive 
      factors in glucose metabolism for progression of hepatic fibrosis in patients 
      with NAFLD by the 75-g oral glucose tolerance test (75gOGTT) and a continuous 
      glucose monitoring system (CGMS). One hundred sixty-nine patients (68 female and 
      101 male patients) with biopsy-proven NAFLD with performance with 75gOGTT were 
      enrolled and divided into four groups according to the stage of hepatic fibrosis 
      (F0-3). The proportion of patients with T2DM significantly gradually increased, 
      HbA1c and the homeostasis model assessment of insulin resistance were 
      significantly elevated, and 1,5-anhydroglucitol (1,5-AG) was remarkably decreased 
      with the progression of fibrosis. In the 75gOGTT, both plasma glucose and insulin 
      secretion were remarkably increased with the progression of fibrosis. The only 
      factor significantly associated with advanced fibrosis was 1,5-AG (P = 0.008) as 
      determined by multivariate logistic regression analysis. We next evaluated the 
      changes in blood glucose during 24 hours by monitoring with the CGMS to confirm 
      the relationship between glycemic variability and progression of fibrosis. 
      Variability of median glucose, standard deviation of median glucose (P = 0.0022), 
      maximum blood glucose (P = 0.0019), and DeltaMin-max blood glucose (P = 0.0029) were 
      remarkably higher in severe fibrosis than in mild fibrosis. CONCLUSION: 
      Hyperinsulinemia and hyperglycemia, especially glycemic variability, are 
      important predictive factors in glucose impairment for the progression of hepatic 
      fibrosis in NAFLD.
FAU - Hashiba, Motoi
AU  - Hashiba M
AD  - Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, 
      Japan.
FAU - Ono, Masafumi
AU  - Ono M
FAU - Hyogo, Hideyuki
AU  - Hyogo H
FAU - Ikeda, Yukio
AU  - Ikeda Y
FAU - Masuda, Kosei
AU  - Masuda K
FAU - Yoshioka, Reiko
AU  - Yoshioka R
FAU - Ishikawa, Yoichi
AU  - Ishikawa Y
FAU - Nagata, Yuri
AU  - Nagata Y
FAU - Munekage, Kensuke
AU  - Munekage K
FAU - Ochi, Tsunehiro
AU  - Ochi T
FAU - Hirose, Akira
AU  - Hirose A
FAU - Nozaki-Fujimura, Yasuko
AU  - Nozaki-Fujimura Y
FAU - Noguchi, Shuhei
AU  - Noguchi S
FAU - Okamoto, Nobuto
AU  - Okamoto N
FAU - Chayama, Kazuaki
AU  - Chayama K
FAU - Suganuma, Narufumi
AU  - Suganuma N
FAU - Saibara, Toshiji
AU  - Saibara T
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131106
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Insulin)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 54BB3B7XMZ (1,5-anhydroglucitol)
RN  - 9G2MP84A8W (Deoxyglucose)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Glucose
MH  - Deoxyglucose/blood
MH  - Disease Progression
MH  - Fatty Liver/*blood/complications/pathology
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Insulin/blood/metabolism
MH  - Insulin Secretion
MH  - Liver Cirrhosis/*blood/etiology/pathology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Non-alcoholic Fatty Liver Disease
MH  - Prognosis
PMC - PMC3819352
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2013/11/14 06:00
MHDA- 2014/08/21 06:00
PMCR- 2013/11/06
CRDT- 2013/11/14 06:00
PHST- 2013/07/02 00:00 [received]
PHST- 2013/08/20 00:00 [accepted]
PHST- 2013/11/14 06:00 [entrez]
PHST- 2013/11/14 06:00 [pubmed]
PHST- 2014/08/21 06:00 [medline]
PHST- 2013/11/06 00:00 [pmc-release]
AID - PONE-D-13-27227 [pii]
AID - 10.1371/journal.pone.0076161 [doi]
PST - epublish
SO  - PLoS One. 2013 Nov 6;8(11):e76161. doi: 10.1371/journal.pone.0076161. eCollection 
      2013.