Younger women with non-alcoholic fatty liver disease are at almost five times greater risk of type 2 diabetes, according to new research.
This far exceeded that observed in older women and men, who were around twice as likely to develop diabetes if they had the liver condition.
The international study also shows for the first time how fatty liver disease can be used to improve risk prediction of type 2 diabetes.
Southampton’s Professor Chris Byrne collaborated on the cohort study of over 245,000 people in South Korea.
Researchers have published their findings in Hepatology.
Progressive liver disease
Non-alcoholic fatty liver disease (NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver. It's usually seen in people who are overweight or obese, and is estimated to affect around a quarter of the world’s population.
It has four stages, where the liver becomes progressively more damaged.
It is known that NALFD can play a role in the development of type 2 diabetes. However the effects of sex and menopausal status on this association remain unclear.
Korean cohort study
This latest research analysed data from 245,054 adults in South Korea who started the programme without diabetes.
The Kangbuk Samsung Health Study included 109,810 premenopausal women, 4,958 postmenopausal women and 130,286 men.
Participants were followed for around five years, with 8,381 going on to develop type 2 diabetes.
Prof Byrne worked with researchers from Kangbuk Samsung Hospital and the University of Edinburgh on the new findings.
Increased risk factor
Overall, a diagnosis of NAFLD was found to more than double the chances of someone developing new type 2 diabetes.
The addition of NAFLD to conventional risk factors improved risk prediction for type 2 diabetes in both sexes, with a greater improvement in women than men.
The analysis found that risk for developing type 2 diabetes was 4.6 times higher in premenopausal women with NAFLD. This compared to a 2.6 times higher risk for postmenopausal women and a 2.16 times higher risk for men.
Prof Byrne, Professor of Endocrinology and Metabolism and Honorary Consultant Diabetologist & Metabolic Physician, said:
“These striking findings suggest that premenopausal women diagnosed with NAFLD should be considered at high risk of type 2 diabetes, and this group should be targeted for diabetes prevention.
“Our study also underscores the need for clinicians to be aware of a possible diagnosis of NAFLD and also to consider age- and sex-specific approaches for diabetes risk assessment and management.”
The research was funded by the NIHR Southampton Biomedical Research Centre and Sungkyunkwan University.