Kui Peng

Validation of the Fatty Liver Index for Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Chinese.

AbstractThe fatty liver index (FLI), which is an algorithm based on waist circumference, body mass index (BMI), triglyceride, and gamma-glutamyl-transferase (GGT), was initially developed to detect fatty liver in Western countries. Our study aimed to evaluate the accuracy and optimal cut-off point of the FLI for predicting nonalcoholic fatty liver disease (NAFLD) in middle-aged and elderly Chinese.This cross-sectional study included 8626 Chinese adults aged 40 years or above recruited from Jiading District, Shanghai, China. Anthropometric and biochemical features were collected by a standard protocol. NAFLD was diagnosed by hepatic ultrasonography. The accuracy and cut-off point of the FLI to detect NAFLD were evaluated by area under the receiver operator characteristic curve (AUROC) and the maximum Youden index analysis, respectively.The AUROC of the FLI for NAFLD was 0.834 (95% confidence interval: 0.825–0.842), and larger than that of its each individual component [0.786 (0.776–0.796), 0.783 (0.773–0.793), 0.727 (0.716–0.739), and 0.707 (0.695–0.719) for waist circumference, BMI, triglyceride, and GGT, respectively] (all P < 0.001). The optimal cut-off point of the FLI for diagnosing NAFLD was 30 with the maximum Youden Index of 0.51, achieving a high sensitivity of 79.89% and a specificity of 71.51%. The FLI-diagnosed NAFLD individuals were in worse metabolic characteristics (waist circumference, BMI, blood pressure, serum lipids, and aminotransferases) than ultrasonography-diagnosed NAFLD patients (all P < 0.05).The FLI could accurately identify NAFLD and the optimal cut-off point was 30 in middle-aged and elderly Chinese. As FLI-diagnosed NAFLD patients were in worse metabolism, much attention should be paid to the metabolic controls and managements of NAFLD.

Diabetes and Risk of Arterial Stiffness: a Mendelian Randomization Analysis

We aimed to explore the causal association between type 2 diabetes (T2D) and increased arterial stiffness. We performed a Mendelian randomization (MR) analysis in 11,385 participants from a well-defined community study in Shanghai during 2011–2013. We genotyped 34 T2D-associated common variants identified in East Asians and created a genetic risk score (GRS). We assessed arterial stiffness noninvasively with the measurement of brachial-ankle pulse wave velocity (baPWV). We used the instrumental variable (IV) estimator to qualify the causal relationship between T2D and increased arterial stiffness. We found each 1-SD increase in T2D_GRS was associated with 6% higher risk in increased arterial stiffness (95% CI 1.01, 1.12), after adjustment of other metabolic confounders. Using T2D_GRS as the IV, we demonstrated a causal relationship between T2D and arterial stiffening (odds ratio 1.24, 95% CI 1.06, 1.47; P = 0.008). When categorizing the genetic loci according to their effect on insulin secretion or resistance, we found genetically determined decrease in insulin secretion was associated with increase in baPWV (βIV = 122.3 cm/s, 95% CI 41.9, 204.6; P = 0.0005). In conclusion, our results provide evidence supporting a causal association between T2D and increased arterial stiffness in a Chinese population.

Metabolically healthy obesity and incident chronic kidney disease: The role of systemic inflammation in a prospective study

To investigate the association between the metabolically healthy obesity (MHO) phenotype and incident chronic kidney disease (CKD) in a Chinese population and whether systemic inflammation affects this association.

Short sleep duration and longer daytime napping are associated with non-alcoholic fatty liver disease in Chinese adults†

Epidemiologic studies have reported conflicting results on the relationship between short sleep duration and non‐alcoholic fatty liver disease (NAFLD). There are no previous studies investigating the effect of daytime napping on NAFLD. In the present study we examined the associations between NAFLD and both nightly sleep duration and daytime napping in a middle‐aged and elderly Chinese population.

Abdominal adiposity contributes to adverse glycemic control and albuminuria in Chinese type 2 diabetic patients: A cross-sectional study.

Abdominal adipose tissue plays an important role in the development of type 2 diabetes. However, few data have suggested its role in the prognosis of diabetes. This study aimed to investigate the association between waist‐hip ratio (WHR), glycemic control, and early nephropathy in Chinese type 2 diabetic patients.

Association between serum CA 19–9 and metabolic syndrome: a cross-sectional study

Increasing evidence suggests that serum CA 19‐9 is associated with abnormal glucose metabolism. However, data on the association between CA 19‐9 and metabolic syndrome is limited. The aim of the present study was to investigate the association between serum CA 19‐9 and metabolic syndrome.

The impact of fat distribution on subclinical coronary atherosclerosis in middle-aged Chinese adults

BACKGROUND The relationship between obesity and cardiovascular disease (CVD) depends not only on the amount of body fat but also on its distribution, which has not been fully investigated in Chinese populations. We aimed to compare measures of fat accumulation in associations with subclinical coronary atherosclerosis in middle-aged Chinese adults. METHODS A total of 548 participants aged 40-60years without previous history or clinical symptoms of CVD were randomly selected to undergo abdominal computed tomography (CT) scanning and coronary CT angiography for the evaluation of subcutaneous and visceral fat accumulation and coronary atherosclerosis, respectively. γ-glutamyltranspeptidase (GGT) was used as a surrogate indicator of liver fat accumulation. RESULTS Measures of obesity such as body-mass index (BMI), waist circumference, visceral fat areas, and GGT levels, but not subcutaneous fat areas increased substantially across groups of participants without coronary stenosis, with <50% stenosis, and with significant (≥50%) stenosis after adjustment for age and sex. The multivariable multinomial logistic regression analysis showed that most obesity indicators such as BMI, waist circumference, visceral fat areas, and GGT levels were significantly associated with risks of having <50% coronary stenosis after adjustment for conventional cardiovascular risk factors. However, only GGT levels were significantly associated with risks of having significant (≥50%) coronary stenosis after adjustment. In addition, no significant associations were found between measures of fat accumulation and coronary calcification. CONCLUSIONS Liver fat accumulation might be more important in the association with subclinical coronary atherosclerosis compared with general and abdominal fat accumulation.

Association between Free Triiodothyronine Levels and Peripheral Arterial Disease in Euthyroid Participants

This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease (PAD) among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine (FT3), free thyroxin (FT4), thyroid-stimulating hormone (TSH), and thyroid antibodies were measured. PAD was defined as ankle-brachial index (ABI) < 0.9. There were 91 (2.9%) PAD cases among the 3,148 euthyroid study participants. Participants in the highest quartile of FT3 and free-triiodothyronine-to-free-thyroxin (FT3/FT4 ratio) had a decreased risk of prevalent PAD (multivariate-adjusted odds ratio, 95% confidence interval: 0.32, 0.15-0.62, P for trend = 0.01 and 0.31, 0.13-0.66, P for trend = 0.004, respectively) compared to those in the lowest quartile. To conclude, FT3 levels and the FT3/FT4 ratio was inversely associated with prevalent PAD in euthyroid Chinese population aged 40 years and above.

Adipose tissue distribution is associated with glycaemic control and microalbuminuria in Chinese patients with type 2 diabetes: a cross-sectional study

Abstract Background Abdominal adipose tissue has an important role in the development of type 2 diabetes. It has also been suggested to be involved in the prognosis of the disease. Therefore, this study aimed to investigate the association between adipose tissue distribution by anthropometric measures, glycaemic control, and microalbuminuria in Chinese patients with type 2 diabetes. Methods A cross-sectional study was done in 1738 patients with clinically diagnosed and new-onset type 2 diabetes (aged 40 years or older) from Shanghai, China. Anthropometric measures and personal information were collected using a standard protocol. Blood samples were obtained for biochemical measurement, and first-voided early-morning spot urine samples were collected for urinary albumin-to-creatinine ratio measurement. This study was approved by the institutional review board of Rui-Jin Hospital affiliated to Shanghai Jiao-Tong University School of Medicine, Shanghai, China. All participants signed consent forms before recruitment. Findings Both waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were significantly associated with fasting (WHR standardised β=0·122 [p 0·93 in men and >0·89 in women) increased the risk of poor glycaemic control (HbA1c >6·5%) by 63% (95% CI 1·31–2·03 [p Interpretation Abdominal adipose tissue has an independent role in the prognoses of type 2 diabetes irrespective of drugs and other intervention. The data also provided evidence on the value of clinical screening by anthropometric measures for identification of patients with type 2 diabetes who are more susceptible to poor glycaemic control and early-stage nephropathy. Funding This study was supported by grants from the National Clinical Research Center for Metabolic Diseases, the National Key New Drug Creation and Manufacturing Program of Ministry of Science and Technology, the National High Technology Research and Development Program of China (863 Program), and the National Natural Science Foundation of China.

Serum Fetuin-A Associated With Fatty Liver Index, Early Indicator of Nonalcoholic Fatty Liver Disease: A Strobe-Compliant Article.

AbstractIncreased fetuin-A has been reported in association with type 2 diabetes and other metabolic diseases. However, the large population data concerning fetuin-A and nonalcoholic fatty liver disease (NAFLD) were limited. In this study, we aimed to investigate the association of serum fetuin-A with fatty liver index (FLI), the indicator of NAFLD.A population-based cross-sectional analysis was performed in 5219 middle-aged and elderly participants who were recruited from 2 nearby urban communities in Shanghai, China. Serum fetuin-A concentrations were measured by enzyme-linked immunosorbent assay (ELISA). The fourth quartiles of FLI, alanine aminotransferance (ALT), aspartate aminotransferance (AST), and &ggr;-glutamyl transpeptadase (GGT) were defined as elevated FLI, ALT, AST, and GGT, respectively.Fetuin-A was positively associated with log-transformed-FLI, -ALT, -AST, and -GGT after adjustment for the confounding factors (all P < 0.05). Multivariate logistic regression analysis showed that each one-standard deviation increase in serum fetuin-A (120.1 mg/L) was associated with 12% (95% confidence interval [CI] 1.01–1.25, P = 0.04), 13% (95% CI 1.06–1.21, P < 0.001), and 10% (95% CI 1.03–1.17, P = 0.005) increased risk of elevated FLI, ALT, and AST, respectively. Categorical analysis showed that as compared to the lowest quartile, the highest quartile of serum fetuin-A associated with a 35% (95% CI 0.98–1.86), 50% (95% CI 1.24–1.83), and 33% (95% CI 1.10–1.60) increased risk of elevated FLI, ALT, and AST, respectively. No significant association was found with GGT.In Chinese adults, serum fetuin-A concentrations were significantly associated with elevated FLI, ALT, and AST, the early indicators of NAFLD.