Article Text
Abstract
Introduction Both fatty liver disease (FLD) and alcohol consumption have been reported to affect incident type 2 diabetes mellitus. The aim of this study was to evaluate the combined effect of FLD and alcohol consumption on incident type 2 diabetes.
Research design and methods In this historical cohort study involving 9948 men, we investigated the influence of the presence of FLD and the grades of alcohol consumption on incident type 2 diabetes using Cox proportional hazards models. We categorized the participants into the following four groups: none or minimal alcohol consumption, <40 g/week; light, 40–140 g/week; moderate, 140–280 g/week; or heavy alcohol consumption, >280 g/week. FLD was diagnosed by abdominal ultrasonography.
Results During the median 6.0-year follow-up, 568 participants developed type 2 diabetes. Heavy alcohol consumers with FLD showed a higher risk for developing type 2 diabetes compared with the other groups. Moderate alcohol consumers without FLD had a significantly higher risk for developing incident type 2 diabetes, compared with none or minimal and light alcohol consumers without FLD. In contrast, there was no apparent difference in the risk for incident type 2 diabetes between none or minimal, light, and moderate alcohol consumers with FLD. Furthermore, there was no statistically significant difference in the risk for incident type 2 diabetes between a moderate and heavy alcohol consumer without FLD and a none or minimal, light, and moderate alcohol consumer with FLD.
Conclusions To prevent incident type 2 diabetes, we should acknowledge that the impact of alcohol consumption may vary in the presence of FLD.
- diabetes mellitus
- type 2
- alcohol drinking
- fatty liver
- epidemiology
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Footnotes
Contributors TO contributed to the data research and analyses and wrote the manuscript. YH originated and designed the study, analyzed the data and reviewed the manuscript for intellectual content. MH contributed to the manuscript organization and reviewed and edited the manuscript. AO and TK originated the study, analyzed the data and contributed to the discussion. MF analyzed the data and reviewed and edited the manuscript. MH is the guarantor of this work and, as such, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors were involved in the writing of the manuscript and approved the manuscript’s final version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The sponsors were not involved in the study design; in the collection, analysis, interpretation of data; in the writing of this manuscript; or in the decision to submit the article for publication.
Competing interests YH has received grants from Asahi Kasei Pharma, personal fees from Daiichi Sankyo, personal fees from Mitsubishi Tanabe Pharma, personal fees from Sanofi KK, personal fees from Novo Nordisk Pharma, outside the submitted work. MH has received grants from Asahi Kasei Pharma, Nippon Boehringer Ingelheim, Mitsubishi Tanabe Pharma, Daiichi Sankyo, Sanofi KK, Takeda Pharmaceutical, Astellas Pharma, Kyowa Kirin, Sumitomo Dainippon Pharma, Novo Nordisk Pharma, and Eli Lilly Japan KK, outside the submitted work. MF has received grants from Nippon Boehringer Ingelheim, Kissei Pharma, Mitsubishi Tanabe Pharma, Daiichi Sankyo, Sanofi KK, Takeda Pharma, Astellas Pharma, MSD KK, Kyowa Hakko Kirin, Sumitomo Dainippon Pharma, Kowa Pharmaceutical, Novo Nordisk Pharma, Ono Pharma, Sanwa Kagaku Kenkyusho, Eli Lilly Japan KK, Taisho Pharma, Terumo, Teijin Pharma, Nippon Chemiphar, Johnson & Johnson KK Medical, Abbott Japan, and received personal fees from Nippon Boehringer Ingelheim, Kissei Pharma, Mitsubishi Tanabe Pharma, Daiichi Sankyo, Sanofi KK, Takeda Pharma, Astellas Pharma, MSD KK, Kyowa Kirin, Sumitomo Dainippon Pharma, Kowa Pharma, Novo Nordisk Pharma, Ono Pharma, Sanwa Kagaku Kenkyusho, Eli Lilly Japan KK, Taisho Pharma, Bayer Yakuhin, AstraZeneca KK, Mochida Pharma, Abbott Japan, Medtronic Japan, Arkley, Teijin Pharma and Nipro, outside the submitted work.
Patient consent for publication Not required.
Ethics approval The study was approved by the Ethics Committee of Asahi University Hospital (IRB number: 2018-09-01), and written informed consent was obtained from each participant.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.