{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T08:23:44Z","timestamp":1785659024476,"version":"3.56.0"},"reference-count":34,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>There is little information about fatty liver in prediabetes as it transitions to early diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study is aimed at evaluating the prevalence and determinants of fatty liver in the Diabetes Prevention Program (DPP).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We measured liver fat as liver attenuation (LA) in Hounsfield units (HU) in 1876 participants at ~14 years following randomization into the DPP, which tested the effects of lifestyle or metformin interventions versus standard care to prevent diabetes. LA was compared among intervention groups and in those with versus without diabetes, and associations with baseline and follow-up measurements of anthropometric and metabolic covariates were assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were no differences in liver fat between treatment groups at 14 years of follow-up. Participants with diabetes had lower LA (mean \u00b1 SD: 46 \u00b1 16 vs 51 \u00b1 14 HU; P &amp;lt; 0.001) and a greater prevalence of fatty liver (LA &amp;lt; 40 HU) (34% vs 17%; P &amp;lt; 0.001). Severity of metabolic abnormalities at the time of LA evaluation was associated with lower LA categories in a graded manner and more strongly in those with diabetes. Averaged annual fasting insulin (an index of insulin resistance [OR, 95% CI 1.76, 1.41-2.20]) waist circumference (1.63, 1.17-2.26), and triglyceride (1.42, 1.13-1.78), but not glucose, were independently associated with LA &amp;lt; 40 HU prevalence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Fatty liver is common in the early phases of diabetes development. The association of LA with insulin resistance, waist circumference, and triglyceride levels emphasizes the importance of these markers for hepatic steatosis in this population and that assessment of hepatic fat in early diabetes development is warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgab160","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T17:54:32Z","timestamp":1615485272000},"page":"e4746-e4765","source":"Crossref","is-referenced-by-count":7,"title":["Hepatic Fat in Participants With and Without Incident Diabetes in the Diabetes Prevention Program Outcome Study"],"prefix":"10.1210","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0924-1110","authenticated-orcid":false,"given":"Ronald B","family":"Goldberg","sequence":"first","affiliation":[{"name":"Diabetes Research Institute, Division of Endocrinology, Diabetes and Metabolism, University of Miami Miller School of Medicine, Miami, FL 33136USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T","family":"Tripputi","sequence":"additional","affiliation":[{"name":"Milken Institute School of Public Health and Health Services, The Biostatistics Center, George Washington University, Rockville, MD 20852USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J","family":"Boyko","sequence":"additional","affiliation":[{"name":"University of Washington, Department of Medicine, Seattle, WA 98108USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Budoff","sequence":"additional","affiliation":[{"name":"Los Angeles Biomedical Research Institute, Torrance CA 90502USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsu-Zsu","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Bone, and Metabolism, Beth Israel Deaconess Medical Center, Harvard, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne M","family":"Clark","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, The Johns Hopkins University, Baltimore MD 21287USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana M","family":"Dabelea","sequence":"additional","affiliation":[{"name":"Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8457-4404","authenticated-orcid":false,"given":"Sharon L","family":"Edelstein","sequence":"additional","affiliation":[{"name":"Milken Institute School of Public Health and Health Services, The Biostatistics Center, George Washington University, Rockville, MD 20852USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E","family":"Gerszten","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Horton","sequence":"additional","affiliation":[{"name":"Joslin Diabetes Center, Boston, MA 02215USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieren J","family":"Mather","sequence":"additional","affiliation":[{"name":"Indiana University of Medicine, Indianapolis IN 46202USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Perreault","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO 80045USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinella","family":"Temprosa","sequence":"additional","affiliation":[{"name":"Milken Institute School of Public Health and Health Services, The Biostatistics Center, George Washington University, Rockville, MD 20852USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amisha","family":"Wallia","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Chicago IL 60610USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karol","family":"Watson","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA, Los Angeles, CA 90095USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeb","family":"Irfan","sequence":"additional","affiliation":[{"name":"J. 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