Arase et al identified risk factors for diabetes mellitus developing in a patient with nonalcoholic fatty liver disease (nonalcoholic steatohepatitis, NASH). A patient with nonalcoholic fatty liver disease is at risk for the metabolic syndrome. but some of the factors are reversible. The authors are from Toranomon Hospital in Tokyo and the University of Yamanashi in Japan.


Patient selection: nonalcoholic fatty liver disease (NAFLD) without diabetes


Risk factors for the development of diabetes mellitus:

(1) prediabetes

(2) elevated serum GGT (> 109 IU/L)

(3) elevated serum triglyceride concentration (> 150 mg/dL)

(4) physical inactivity (less than 1 hour of physical activity per week)



• The odds ratio for prediabetes 6.4 while the other 3 factors had odd ratios from 1.3 to 1.6.


Patients who modified their lifestyle with increased physical activity were often able to avoid development of diabetes. These patients:

(1) normalized their blood glucose level

(2) normalized the serum GGT

(3) lowered their serum triglyceride levels


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