{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:25:52Z","timestamp":1790749552427,"version":"4.1.0"},"reference-count":38,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":3459,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,4,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n                  <jats:sec>\n                     <jats:title>OBJECTIVE<\/jats:title>\n                     <jats:p>Prediabetes and type 2 diabetes mellitus (T2DM) are believed to be common and associated with a worse metabolic profile in patients with nonalcoholic fatty liver disease (NAFLD). However, no previous study has systematically screened this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                     <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                     <jats:p>We studied the prevalence and the metabolic impact of prediabetes and T2DM in 118 patients with NAFLD. The control group comprised 20 subjects without NAFLD matched for age, sex, and adiposity. We measured 1) plasma glucose, insulin, and free fatty acid (FFA) concentration during an oral glucose tolerance test; 2) liver fat by magnetic resonance spectroscopy (MRS); 3) liver and muscle insulin sensitivity (euglycemic insulin clamp with 3-[3H]glucose); and 4) indexes of insulin resistance (IR) at the level of the liver (HIRi= endogenous glucose production \u00d7 fasting plasma insulin [FPI]) and adipose tissue (Adipo-IRi= fasting FFA \u00d7 FPI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                     <jats:title>RESULTS<\/jats:title>\n                     <jats:p>Prediabetes and T2DM was present in 85% versus 30% in controls (P &amp;lt; 0.0001), all unaware of having abnormal glucose metabolism. NAFLD patients were IR at the level of the adipose tissue, liver, and muscle (all P &amp;lt; 0.01\u20130.001). Muscle and liver insulin sensitivity were impaired in patients with NAFLD to a similar degree, whether they had prediabetes or T2DM. Only adipose tissue IR worsened in T2DM and correlated with the severity of muscle (r = 0.34; P &amp;lt; 0.001) and hepatic (r = 0.57; P &amp;lt; 0.0001) IR and steatosis by MRS (r = 0.35; P &amp;lt; 0.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                     <jats:title>CONCLUSIONS<\/jats:title>\n                     <jats:p>Patients with NAFLD may benefit from early screening for T2DM, because the prevalence of abnormal glucose metabolism is much higher than previously appreciated. Regardless of glucose tolerance status, severe IR is common. In patients with T2DM, adipose tissue IR appears to play a major role in the severity of NAFLD.<\/jats:p>\n                  <\/jats:sec>\n               <\/jats:sec>","DOI":"10.2337\/dc11-1849","type":"journal-article","created":{"date-parts":[[2012,2,29]],"date-time":"2012-02-29T05:15:59Z","timestamp":1330492559000},"page":"873-878","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":213,"title":["Prevalence of Prediabetes and Diabetes and Metabolic Profile of Patients With Nonalcoholic Fatty Liver Disease (NAFLD)"],"prefix":"10.2337","volume":"35","author":[{"given":"Carolina","family":"Ortiz-Lopez","sequence":"first","affiliation":[{"name":"Division of Diabetes, The University of Texas Health Science Center at San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Lomonaco","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Orsak","sequence":"additional","affiliation":[{"name":"Division of Diabetes, The University of Texas Health Science Center at San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Finch","sequence":"additional","affiliation":[{"name":"Audie L. Murphy Veterans Administration Medical Center, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Diabetes, The University of Texas Health Science Center at San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria G.","family":"Kochunov","sequence":"additional","affiliation":[{"name":"Research Imaging Center of The University of Texas Health Science Center at San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Hardies","sequence":"additional","affiliation":[{"name":"Research Imaging Center of The University of Texas Health Science Center at San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Cusi","sequence":"additional","affiliation":[{"name":"Division of Diabetes, The University of Texas Health Science Center at San Antonio, San Antonio, Texas"},{"name":"Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, Florida"},{"name":"Audie L. Murphy Veterans Administration Medical Center, San Antonio, Texas"},{"name":"Malcolm Randall Veterans Administration Medical Center, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2012,3,13]]},"reference":[{"key":"2022031302310096700_B1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1159\/000282081","article-title":"The natural history of non-alcoholic fatty liver disease","volume":"28","author":"Caldwell","year":"2010","journal-title":"Dig Dis"},{"key":"2022031302310096700_B2","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1002\/hep.23784","article-title":"Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease","volume":"52","author":"Neuschwander-Tetri","year":"2010","journal-title":"Hepatology"},{"key":"2022031302310096700_B3","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1111\/j.1440-1746.2004.03312.x","article-title":"Non-alcoholic steatohepatitis in type 2 diabetes mellitus","volume":"19","author":"Gupte","year":"2004","journal-title":"J Gastroenterol Hepatol"},{"key":"2022031302310096700_B4","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1038\/nrendo.2011.72","article-title":"Nonalcoholic fatty liver disease and diabetes mellitus: pathogenesis and treatment","volume":"7","author":"Smith","year":"2011","journal-title":"Nat Rev Endocrinol"},{"key":"2022031302310096700_B5","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1002\/hep.24483","article-title":"Role of ethnicity in overweight and obese patients with nonalcoholic steatohepatitis","volume":"54","author":"Lomonaco","year":"2011","journal-title":"Hepatology"},{"key":"2022031302310096700_B6","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1002\/hep.20466","article-title":"Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity","volume":"40","author":"Browning","year":"2004","journal-title":"Hepatology"},{"key":"2022031302310096700_B7","unstructured":"Centers for Disease Control and Prevention. 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