PMID- 37169306 OWN - NLM STAT- MEDLINE DCOM- 20230606 LR - 20230606 IS - 1872-8227 (Electronic) IS - 0168-8227 (Linking) VI - 200 DP - 2023 Jun TI - Lean nonalcoholic fatty liver disease and risk of incident type 2 diabetes mellitus: A literature review and meta-analysis. PG - 110699 LID - S0168-8227(23)00462-X [pii] LID - 10.1016/j.diabres.2023.110699 [doi] AB - OBJECTIVE: There is limited data regarding the risk of incident type 2 diabetes mellitus (T2DM) among lean nonalcoholic fatty liver disease (NAFLD) individuals. We performed a meta-analysis of relevant studies. RESEARCH DESIGN AND METHODS: We collected data using PubMed, Scopus, Cochrane and Web of Science from the databases' inception until December 2022. We included cohort studies in which lean NAFLD was diagnosed through imaging methods or biopsy. Eligible studies were selected according to predefined keywords and clinical outcomes. RESULTS: A total of 16 observational studies with 304,975 adult individuals (7.7% with lean NAFLD) and nearly 1300 cases of incident diabetes followed up over a median period of 5.05 years were included in the final analysis. Patients with lean NAFLD had a greater risk of incident diabetes than those without NAFLD (random-effects hazard ratio [HR] 2.72, 95% CI 1.56-4.74; I(2) = 93.8%). Compared with the lean without NAFLD group, the adjusted HRs (95% CIs) of incident diabetes for participants in the overweight/obese without NAFLD and overweight/obese with NAFLD groups were 1.32 (0.99- 1.77) and 2.98(1.66-5.32). It appeared to be even greater among NAFLD patients with advanced high NAFLD fibrosis score (random-effects HR 3.48, 95% CI 1.92-6.31). Sensitivity analyses and publication bias did not alter these findings. CONCLUSIONS: Lean NAFLD is significantly associated with at least twofold increased risk of incident diabetes in non-overweight subjects. This risk parallels the underlying severity of NAFLD. The presence of NAFLD in non-overweight individuals had a more significant impact on the development of diabetes than being overweight itself. CI - Copyright (c) 2023. Published by Elsevier B.V. FAU - Gao, Yuting AU - Gao Y AD - Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. FAU - Zhao, Tianyi AU - Zhao T AD - Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. FAU - Song, Shuoning AU - Song S AD - Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. FAU - Duo, Yanbei AU - Duo Y AD - Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. FAU - Gao, Junxiang AU - Gao J AD - Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. FAU - Yuan, Tao AU - Yuan T AD - Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. Electronic address: t75y@sina.com. FAU - Zhao, Weigang AU - Zhao W AD - Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. Electronic address: xiehezhaoweigang@163.com. LA - eng PT - Journal Article PT - Meta-Analysis PT - Review DEP - 20230509 PL - Ireland TA - Diabetes Res Clin Pract JT - Diabetes research and clinical practice JID - 8508335 SB - IM MH - Adult MH - Humans MH - *Non-alcoholic Fatty Liver Disease/complications/epidemiology/pathology MH - *Diabetes Mellitus, Type 2/epidemiology/complications MH - Obesity/complications/epidemiology MH - Overweight/complications MH - Cohort Studies OTO - NOTNLM OT - Lean OT - NAFLD OT - Nonalcoholic fatty liver disease OT - Obesity OT - Risk of diabetes COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/05/12 01:07 MHDA- 2023/06/06 06:42 CRDT- 2023/05/11 19:37 PHST- 2023/04/06 00:00 [received] PHST- 2023/05/02 00:00 [revised] PHST- 2023/05/04 00:00 [accepted] PHST- 2023/06/06 06:42 [medline] PHST- 2023/05/12 01:07 [pubmed] PHST- 2023/05/11 19:37 [entrez] AID - S0168-8227(23)00462-X [pii] AID - 10.1016/j.diabres.2023.110699 [doi] PST - ppublish SO - Diabetes Res Clin Pract. 2023 Jun;200:110699. doi: 10.1016/j.diabres.2023.110699. Epub 2023 May 9.