Non-Alcoholic Fatty Liver Disease and Risk of Incident Type 2 Diabetes: Role of Circulating Branched-Chain Amino Acids. 2019

Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
Department of Endocrinology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands. e.h.van.den.berg@umcg.nl.

Non-alcoholic fatty liver disease (NAFLD) is likely to be associated with elevated plasma branched-chain amino acids (BCAAs) and may precede the development of type 2 diabetes (T2D). We hypothesized that BCAAs may be involved in the pathogenesis of T2D attributable to NAFLD and determined the extent to which plasma BCAAs influence T2D development in NAFLD. We evaluated cross-sectional associations of NAFLD with fasting plasma BCAAs (nuclear magnetic resonance spectroscopy), and prospectively determined the extent to which the influence of NAFLD on incident T2D is attributable to BCAA elevations. In the current study, 5791 Prevention of REnal and Vascular ENd-stage Disease (PREVEND) cohort participants without T2D at baseline were included. Elevated fatty liver index (FLI) ≥60, an algorithm based on triglycerides, gamma-glutamyltransferase, body mass index (BMI) and waist circumference, was used as proxy of NAFLD. Elevated FLI ≥ 60 was present in 1671 (28.9%) participants. Cross-sectionally, BCAAs were positively associated with FLI ≥ 60 (β = 0.208, p < 0.001). During a median follow-up of 7.3 years, 276 participants developed T2D, of which 194 (70.2%) had an FLI ≥ 60 (log-rank test, p < 0.001). Cox regression analyses revealed that both FLI ≥60 (hazard ratio (HR) 3.46, 95% CI 2.45⁻4.87, p < 0.001) and higher BCAA levels (HR 1.19, 95% CI 1.03⁻1.37, p = 0.01) were positively associated with incident T2D. Mediation analysis showed that the association of FLI with incident T2D was in part attributable to elevated BCAAs (proportion mediated 19.6%). In conclusion, both elevated FLI and elevated plasma BCAA levels are associated with risk of incident T2D. The association of NAFLD with T2D development seems partly mediated by elevated BCAAs.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003924 Diabetes Mellitus, Type 2 A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY. Diabetes Mellitus, Adult-Onset,Diabetes Mellitus, Ketosis-Resistant,Diabetes Mellitus, Maturity-Onset,Diabetes Mellitus, Non-Insulin-Dependent,Diabetes Mellitus, Slow-Onset,Diabetes Mellitus, Stable,MODY,Maturity-Onset Diabetes Mellitus,NIDDM,Diabetes Mellitus, Non Insulin Dependent,Diabetes Mellitus, Noninsulin Dependent,Diabetes Mellitus, Noninsulin-Dependent,Diabetes Mellitus, Type II,Maturity-Onset Diabetes,Noninsulin-Dependent Diabetes Mellitus,Type 2 Diabetes,Type 2 Diabetes Mellitus,Adult-Onset Diabetes Mellitus,Diabetes Mellitus, Adult Onset,Diabetes Mellitus, Ketosis Resistant,Diabetes Mellitus, Maturity Onset,Diabetes Mellitus, Slow Onset,Diabetes, Maturity-Onset,Diabetes, Type 2,Ketosis-Resistant Diabetes Mellitus,Maturity Onset Diabetes,Maturity Onset Diabetes Mellitus,Non-Insulin-Dependent Diabetes Mellitus,Noninsulin Dependent Diabetes Mellitus,Slow-Onset Diabetes Mellitus,Stable Diabetes Mellitus
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000597 Amino Acids, Branched-Chain Amino acids which have a branched carbon chain. Branched-Chain Amino Acid,Amino Acids, Branched Chain,Acid, Branched-Chain Amino,Acids, Branched-Chain Amino,Amino Acid, Branched-Chain,Branched Chain Amino Acid,Branched-Chain Amino Acids
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D065626 Non-alcoholic Fatty Liver Disease Fatty liver finding without excessive ALCOHOL CONSUMPTION. Fatty Liver, Nonalcoholic,NAFLD,Nonalcoholic Fatty Liver Disease,Nonalcoholic Steatohepatitis,Fatty Livers, Nonalcoholic,Liver, Nonalcoholic Fatty,Livers, Nonalcoholic Fatty,Non alcoholic Fatty Liver Disease,Nonalcoholic Fatty Liver,Nonalcoholic Fatty Livers,Nonalcoholic Steatohepatitides,Steatohepatitides, Nonalcoholic,Steatohepatitis, Nonalcoholic

Related Publications

Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
April 2022, International journal of molecular sciences,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
March 2023, Nutrients,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
August 2022, Journal of gastroenterology and hepatology,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
December 2021, Annals of medicine,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
March 2020, Diabetes/metabolism research and reviews,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
June 2016, Best practice & research. Clinical endocrinology & metabolism,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
August 2019, Hepatology research : the official journal of the Japan Society of Hepatology,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
December 2018, Journal of clinical medicine,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
April 2024, Journal of the American Heart Association,
Eline H van den Berg, and Jose L Flores-Guerrero, and Eke G Gruppen, and Martin H de Borst, and Justyna Wolak-Dinsmore, and Margery A Connelly, and Stephan J L Bakker, and Robin P F Dullaart
February 2018, Hepatology research : the official journal of the Japan Society of Hepatology,
Copied contents to your clipboard!