Figure 1.
Relationship between glucose impairment and progression of hepatic fibrosis.
The frequencies of NGT, IGT/IFG, and T2DM in the four stages of hepatic fibrosis are shown. The diagnosis of glucose impairment was based on the 75gOGTT. The prevalence of NGT in patients in the F0 group (80.0%) was significantly higher than that in the F1 (43.2%), F2 (31.3%), and F3 groups (21.6%), and the frequencies of patients with T2DM in the F3 group (48.6%) was significantly higher than that in the F0 (0%), F1 (22.9%), and F2 (35.4%) groups. P-values were calculated using the X2-test. Fibrosis stage (F): F0 (n = 10), F1 (n = 74), F2 (n = 48), F3 (n = 37); total, N = 169.
Table 1.
Clinical and physiological characteristics of patients with NAFLD in the four stages of hepatic fibrosis.
Figure 2.
Relationship between hepatic fibrosis and various parameters of glucose metabolism.
A) HbA1c was significantly elevated in accordance with the progression of hepatic fibrosis (F0 versus F2, *P<0.05; F0 versus F3, **P<0.05; N = 169). B) 1,5-Anhydroglucitol (1,5-AG) levels were remarkably decreased with the progression of hepatic fibrosis (F0 versus F2, *P<0.05; F0 versus F3, ****P<0.0001; F1 versus F3, ***P<0.001; F2 versus F3, *P<0.05; N = 169). C) HOMA-IR was significantly elevated in the patients with advanced hepatic fibrosis (F0 versus F2, *P<0.05; F0 versus F3, *P<0.05; F1 versus F2, *P<0.05; F1 versus F3, **P<0.01; N = 169). D) The insulinogenic index did not differ among the fibrosis groups (N = 169).
Figure 3.
Patterns of glucose and insulin secretion in the 75gOGTT in relation to the progression of hepatic fibrosis.
A) The glucose levels were significantly elevated in accordance with the progression of fibrosis (Versus F0: *P<0.05, **P<0.01; Versus F1: #P<0.05, ###P<0.001; Versus F2: +P<0.05). B) Area under the curve (AUC) of plasma glucose levels (AUC-PG) was remarkably larger in accordance with the progression of hepatic fibrosis (F0 versus F2, *P<0.05; F0 versus F3, **P<0.01; F1 versus F3, #P<0.05; F2 versus F3, +P<0.05) C) Insulin secretion levels were remarkably higher in the patients with progression of hepatic fibrosis (Versus F0: *P<0.05, **P<0.01; Versus F1: #P<0.05, ##P<0.01, ###P<0.001). D) AUC of insulin secretion (AUC-IRI) was also significantly larger in accordance with the progression of hepatic fibrosis (F0 versus F3, *P<0.05; F1 versus F3, ##P<0.01). (Black diamond: F0: n = 10. Gray square: F1: n = 74. Black triangle: F2: n = 48. Gray circle: F3: n = 37; total, N = 169).
Table 2.
Comparison of the parameters of glucose metabolism between patients with mild fibrosis (F0–2) and severe fibrosis (F3).
Table 3.
Factors associated with progression of hepatic fibrosis in multivariate logistic regression analysis.
Table 4.
Comparison of variable parameters of continuous glucose monitoring between patients with mild fibrosis (F0–2) and severe fibrosis (F3–4).
Twenty-four-hour sensor glucose profiles by continuous glucose monitoring system.
The changes in the median sensor glucose levels during 24) mild fibrosis (F0–2, n = 10) and B) severe fibrosis (F3–4, n = 10). The variability of median glucose levels among the patients with mild fibrosis was remarkably smaller than that among the patients with severe fibrosis. Median glucose levels in the patients with severe fibrosis were higher than those with mild fibrosis (shadows areas, P<0.05 to P<0.001). Black diamond: Time of meal consumption.