Fatty liver index and risk of diabetes incidence: A systematic review and dose-response meta-analysis of cohort studies

• Published in: Primary care diabetes Vol. 14; no. 6; pp. 577 - 583
• Main Authors: Movahedian, Mina, Rahmani, Jamal, Hashemi Nazari, Seyed Saeed, Mohamadi, Susan, Naik, Gurudatta, Hekmatdoost, Azita
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2020
• Subjects: Diabetes; Dose-response; Fatty liver; FLD; FLI; RR; T2DM; FLI; OR; Fatty liver; CI; Dose-response; HR; Diabetes; FLD
• ISSN: 1751-9918; 1878-0210
• DOI: 10.1016/j.pcd.2020.02.011

•The first dose-response meta-analysis to assess the relation between FLI and T2DM.•In 21 studies positive relation between FLI and diabetes incidence was identified.•Individuals with higher FLI had a significantly higher risk of diabetes incidence.
Fatty Liver Index (FLI) is a surrogate index for diagnosis of Fatty Liver Disease (FLD). We performed a dose-response meta-analysis to investigate the relationship between FLI and diabetes incidence in prospective cohort studies.
We conducted a systematic search of articles up to November 2019 in PubMed, SCOPUS, Cochrane library, and Embase. Hazard Ratios (HRs) with corresponding 95% confidence intervals (CIs) of studies were pooled using meta-analysis with DerSimonian and Laird random-effects models to find combined HRs. Dose-response effect of this relationship was also assessed.
Twenty-seven studies providing 70,918 participants were included in the meta-analysis. Pooled results showed that the highest category of FLI was associated with an increased incidence of diabetes [HR: 2.88, 95% CI: 2.18–3.81; P for heterogeneity: 0.001]. Subgroup analysis based on sex, continent, and the quality of study could not explain the source of heterogeneity. The pooled HR from the random-effects dose-response model indicated a significant association between FLI level and risk of diabetes incidence (Coef=0.0239, p=0.001).
Our dose-response meta-analysis revealed a direct relationship between FLI and HR of diabetes incidence.