Transient remission of nonalcoholic fatty liver disease decreases the risk of incident type 2 diabetes mellitus in Japanese men.
BACKGROUND
It is unclear how the transient remission of nonalcoholic fatty liver disease (NAFLD) affects incident type 2 diabetes mellitus (T2DM). Here, we sought to determine the effect of the transient remission of NAFLD on incident T2DM in Japanese men.


METHODS
We used a population-based health check-up program. The primary outcome was set as incident T2DM. We divided the participants who showed NAFLD at the time of enrollment into three groups according to their clinical course of NAFLD: the Regression group, in which the participants showed a regression of NAFLD and no relapse during the follow-up period; the Transient Remission group, in which participants achieved a transient remission of NAFLD, but had a relapse of NAFLD; and the Persistent group, in which participants showed NAFLD throughout the follow-up. The Never group of participants who did not show NAFLD throughout the follow-up served as a reference.


RESULTS
The incidence rates of T2DM in the Never group, the Regression group, the Transient Remission group, and the Persistent group were 4.7% (62/1306), 9.2% (14/153), 18.0% (25/139), and 35.1% (120/342), respectively. In a multivariate Cox regression analysis with covariates, the adjusted hazard ratios for incident T2DM compared with the Never group were as follows: Regression group: 1.08 [95% confidence interval (CI) 0.53-2.04, P=0.81], Transient Remission group: 2.12 (95% CI 1.22-3.57, P<0.01), and Persistent group: 3.44 (95% CI 2.29-5.21, P<0.001). The adjusted hazard ratio of the Transient Remission group was significantly lower than that of the Persistent group (P<0.05).


CONCLUSIONS
Transient remission of NAFLD significantly decreased the risk of developing T2DM.
aDepartment of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine bDepartment of Diabetology, Kameoka Municipal Hospital cDepartment of Internal Medicine, Aiseikai Yamashina Hospital, Kyoto dDepartment of Gastroenterology, Murakami Memorial Hospital, Asahi University, Gifu, Japan.
Takuya
T
Fukuda
Masahide
M
Hamaguchi
Takao
T
Kojima
Kazuteru
K
Mitsuhashi
Yoshitaka
Y
Hashimoto
Akihiro
A
Ohbora
Takahiro
T
Kato
Naoto
N
Nakamura
Michiaki
M
Fukui
D000328:Adult; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D016016:Proportional Hazards Models; D012008:Recurrence; D012075:Remission, Spontaneous; D012307:Risk Factors; D014463:Ultrasonography