Ultrasound-Diagnosed Nonalcoholic Fatty Liver Disease Independently Predicts a Higher Risk of Developing Diabetes Mellitus in Nonoverweight Individuals

Rationale and Objectives: This study was aimed to evaluate the independent value of ultrasound-diagnosed nonalcoholic fatty liver disease (us-NAFLD), as a surrogate imaging marker of the pathologic entity of NAFLD, in predicting incident diabetes mellitus (DM) in nonoverweight individuals. Materials and Methods: A total of 10,064 participants who had a body mass index <23 kg/m(2) were included in this retrospective cohort study. us-NAFLD was diagnosed using abdominal ultrasound. All participants were divided into subgroups according to the presence or absence of us-NAFLD and metabolic syndrome (MS). Results: Over a mean follow-up of 6.0 years, 125 participants (1.2%) developed DM. The incidence rates of DM were 1.0% in participants without us-NAFLD, 6.2% in participants with us-NAFLD, 1.1% in participants without MS, and 13.2% in participants with MS. The adjusted hazard ratios for incident DM were 2.52 (95% confidence interval:1.58-4.03) for us-NAFLD and 2.64 (95% confidence interval:1.54-4.54) for MS. Conclusion: This study demonstrates that us-NAFLD has an independent value in predicting incident DM in non-overweight individuals.