title: Lipid and liver abnormalities in haemoglobin A1c-defined prediabetes and type 2 diabetes.
abstract: OBJECTIVE
  We aimed to investigate lipid abnormalities and liver steatosis in patients with HbA1c-defined prediabetes and type 2 diabetes compared to individuals with HbA1c-defined normoglycaemia.
  
  
  RESULTS
  Ninety-one subjects with prediabetes according to HbA1c, i.e. from 5.7 to 6.4% (39-46 mmol/mol), 50 newly diagnosed patients with HbA1c-defined type 2 diabetes (HbA1c ≥6.5% [≥48 mmol/mol]), and 67 controls with HbA1c lower than 5.7% (<39 mmol/mol), were studied. Fasting blood samples for lipid profiles, fatty liver index (FLI), bioimpedance analysis, ultrasound scan of the liver, and BARD (body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes) score for evaluation of liver fibrosis, were performed in all subjects. In comparison to controls, subjects with prediabetes were characterised by: lower apolipoprotein AI and HDL cholesterol levels, higher blood pressure, triglycerides levels and apolipoprotein B/apolipoprotein AI ratio, higher FLI, increased prevalence of and more severe hepatic steatosis, similar BARD score, and higher total body fat mass. In comparison to subjects with diabetes, subjects with prediabetes exhibited: similar blood pressure and apolipoprotein B/apolipoprotein AI ratio, similar FLI, reduced prevalence of and less severe hepatic steatosis, lower BARD score, increased percent fat and lower total body muscle mass. In comparison to controls, subjects with diabetes showed: lower apolipoprotein AI and HDL cholesterol levels, higher blood pressure and triglycerides levels, higher FLI, increased prevalence of and more severe hepatic steatosis, higher BARD score, and higher total body muscle mass. Moreover, HbA1c was correlated with BMI, HOMA-IR, triglycerides, HDL cholesterol, AST, and ALT.
  
  
  CONCLUSIONS
  Subjects with HbA1c-defined prediabetes and type 2 diabetes, respectively, are characterised by abnormalities in lipid profile and liver steatosis, thus exhibiting a severe risk profile for cardiovascular and liver diseases.
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Calanna
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Scicali
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Pino
authors.affiliation: Diabetes Research Division, Department of Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: F K
authors.initials: FK
authors.lastname: Knop
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Piro
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Rabuazzo
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy. Electronic address: fpurrell@unict.it.
authors.forename: F
authors.initials: F
authors.lastname: Purrello
mesh_terms: D000328:Adult; D016632:Apolipoprotein A-I / Q000097:blood; D001823:Body Composition; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D003925:Diabetic Angiopathies / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007333:Insulin Resistance; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D011236:Prediabetic State / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D014463:Ultrasonography
chemical_list: D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D008055:Lipids; C505693:APOA1 protein, human; C517652:hemoglobin A1c protein, human
keywords: Apolipoprotein; Cardiovascular risk; Liver steatosis; Prediabetes; Type 2 diabetes