Dataset Information

Sex differences in the association between fatty liver and type 2 diabetes incidence in non-obese Japanese: A retrospective cohort study.

ABSTRACT:

Aims/introduction

Asians develop type 2 diabetes at a lower body mass index (BMI) compared with other races, which is partly because of Asian-specific fat depots. Sex plays a role in fat deposition, regardless of race. This retrospective cohort study aimed to investigate the association among fatty liver, sex and type 2 diabetes in non-obese Japanese.

Materials and methods

The participants in this study (13,596 men and 6,037 women) were aged 30-64 years, and had undergone health checkups between 2013 and 2015, in Aichi, Japan. Baseline BMI was categorized as follows: <18.5, 18.5-19.9, 20-22.9, 23-24.9, 25-27.4 and ≥27.5 kg/m² . Fatty liver was diagnosed by abdominal ultrasonography. The joint effect of BMI and fatty liver on the incidence of type 2 diabetes was assessed, stratified by sex.

Results

During follow up, 738 men and 138 women developed type 2 diabetes. Compared with the BMI of 20-22.9 kg/m² without fatty liver group, the BMI of 20-22.9 kg/m² with fatty liver was associated with a higher risk of type 2 diabetes in men, but not in women. Furthermore, men with a BMI of 23-24.9 and 25-27.4 kg/m² without fatty liver had no significant type 2 diabetes risk, whereas women with a BMI of 23-24.9 and 25-27.4 kg/m² , regardless of fatty liver, had an increased risk.

Conclusions

These results suggest the association between fatty liver and type 2 diabetes in non-obese Asians is different by sex; fatty liver increases diabetes risk among male, not female, non-obese Asians.

SUBMITTER: Narisada A

PROVIDER: S-EPMC8354510 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundLittle is known regarding whether sex assigned at birth modifies the association between several predictive factors for dementia and the risk of dementia itself.MethodsOur retrospective cohort study included 214,670 men and 214,670 women matched by age at baseline from the UK Biobank. Baseline data were collected between 2006 and 2010, and incident dementia was ascertained using hospital inpatient or death records until January 2021. Mediation analysis was tested for 133 individual factors.ResultsOver 5,117,381 person-years of follow-up, 5928 cases of incident all-cause dementia (452 cases of young-onset dementia, 5476 cases of late-onset dementia) were documented. Hazard ratios (95% CI) for all-cause, young-onset, and late-onset dementias associated with the male sex (female as reference) were 1.23 (1.17-1.29), 1.42 (1.18-1.71), and 1.21 (1.15-1.28), respectively. Out of 133 individual factors, the strongest mediators for the association between sex and incident dementia were multimorbidity risk score (percentage explained (95% CI): 62.1% (45.2-76.6%)), apolipoprotein A in the blood (25.5% (15.2-39.4%)), creatinine in urine (24.9% (16.1-36.5%)), low-density lipoprotein cholesterol in the blood (23.2% (16.2-32.1%)), and blood lymphocyte percentage (21.1% (14.5-29.5%)). Health-related conditions (percentage (95% CI) explained: 74.4% (51.3-88.9%)) and biomarkers (83.0% (37.5-97.5%)), but not lifestyle factors combined (30.1% (20.7-41.6%)), fully mediated sex differences in incident dementia. Health-related conditions combined were a stronger mediator for late-onset (75.4% (48.6-90.8%)) than for young-onset dementia (52.3% (25.8-77.6%)), whilst lifestyle factors combined were a stronger mediator for young-onset (42.3% (19.4-69.0%)) than for late-onset dementia (26.7% (17.1-39.2%)).ConclusionsOur analysis matched by age has demonstrated that men had a higher risk of all-cause, young-onset, and late-onset dementias than women. This association was fully mediated by health-related conditions or blood/urinary biomarkers and largely mediated by lifestyle factors. Our findings are important for understanding potential mechanisms of sex in dementia risk.