{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:17:24Z","timestamp":1789172244262,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In type 2 diabetes, impaired glucagon action in the liver (hepatic glucagon resistance) may disrupt the liver\u2013\u03b1\u2010cell axis. We examined the associations of fasting glucagon and a modified glucagon\u2013alanine index (GAI) with imaging\u2010derived hepatic steatosis and liver stiffness in Japanese individuals with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cross\u2010sectional analysis of baseline data from the KAMOGAWA\u2010DM cohort. Among patients with type 2 diabetes with fasting glucagon measured, 46 participants were included after exclusions. Liver steatosis was assessed by abdominal ultrasonography using a liver steatosis score, and liver stiffness was quantified by shear\u2010wave elastography (E\u2010value, kPa). Fasting glucagon was measured using a Mercodia enzyme\u2010linked immunosorbent assay (ELISA). The modified GAI was calculated as fasting glucagon (pmol\/L)\u2009\u00d7\u2009alanine (arbitrary units) and log\u2010transformed (Base\u2009=\u200910) for analyses. Group comparisons, correlation analyses, and exploratory receiver operating characteristic (ROC) analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010three participants had metabolic dysfunction\u2010associated steatotic liver disease (MASLD) and 23 did not. Fasting glucagon levels and the\n                      <jats:styled-content style=\"fixed-case\">GAI<\/jats:styled-content>\n                      were significantly higher in\n                      <jats:styled-content style=\"fixed-case\">MASLD<\/jats:styled-content>\n                      group, whereas alanine alone did not differ significantly between groups. Log\u2010transformed fasting glucagon and log\u2010transformed\n                      <jats:styled-content style=\"fixed-case\">GAI<\/jats:styled-content>\n                      were positively correlated with the ultrasonographic liver steatosis score; log\u2010transformed fasting glucagon was also positively correlated with liver stiffness. In exploratory\n                      <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>\n                      analyses, log\u2010transformed fasting glucagon cutoff of 1.511 yielded 82.6% sensitivity and 65.2% specificity, and log\u2010transformed\n                      <jats:styled-content style=\"fixed-case\">GAI<\/jats:styled-content>\n                      of 4.036 yielded 73.9% sensitivity and 81.8% specificity for discriminating\n                      <jats:styled-content style=\"fixed-case\">MASLD.<\/jats:styled-content>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In Japanese individuals with type 2 diabetes, higher fasting glucagon and a higher modified\n                      <jats:styled-content style=\"fixed-case\">GAI<\/jats:styled-content>\n                      were associated with greater imaging\u2010derived liver steatosis. Higher fasting glucagon was also associated with greater liver stiffness. These cross\u2010sectional findings are compatible with, but do not establish, hepatic glucagon resistance or disruption of the liver\u2013\u03b1\u2010cell axis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70854","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:05:41Z","timestamp":1780646741000},"page":"7393-7402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Fasting Glucagon and the Glucagon\u2013Alanine Index With Hepatic Steatosis and Liver Stiffness in Japanese Individuals With Type 2 Diabetes"],"prefix":"10.1111","volume":"28","author":[{"given":"Tomohiro","family":"Hattori","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8651-4445","authenticated-orcid":false,"given":"Masahide","family":"Hamaguchi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3263-9469","authenticated-orcid":false,"given":"Noriyuki","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"},{"name":"Department of Diabetology Kameoka Municipal Hospital  Kameoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Osaka","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"},{"name":"Department of Endocrinology and Diabetology Ayabe City Hospital  Ayabe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-970X","authenticated-orcid":false,"given":"Hiroshi","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoichi","family":"Sasano","sequence":"additional","affiliation":[{"name":"AiSTI Science Co., Ltd.  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