{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T03:54:38Z","timestamp":1785210878401,"version":"3.55.0"},"reference-count":29,"publisher":"Korean Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2017R1D1A3B04028873"],"award-info":[{"award-number":["2017R1D1A3B04028873"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1I1A1A01069493"],"award-info":[{"award-number":["2022R1I1A1A01069493"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002701","name":"Ministry of Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002701","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-enm.org"],"crossmark-restriction":true},"short-container-title":["Endocrinol Metab"],"published-print":{"date-parts":[[2025,12,31]]},"abstract":"<jats:p>Background: Type 2 diabetes mellitus (T2DM) is a significant risk factor for hepatocellular carcinoma (HCC) in patients with nonalcoholic fatty liver disease; however, surveillance strategies for patients with T2DM, especially without cirrhosis, are inadequate. This study examined whether the fatty liver index (FLI) and its dynamic changes can effectively identify patients with T2DM at increased risk for HCC.Methods: Data from 92,761 individuals with T2DM aged 40 to 79 who underwent two health screenings (2012 to 2015) were analyzed. The FLI, calculated using waist circumference, body mass index, triglycerides, and gamma-glutamyl transferase, was used to stratify patients by baseline FLI and FLI changes between screenings. HCC cases were identified via International Classification of Diseases codes and reimbursement records (2016 to 2020).Results: Patients with baseline FLI of 30 to 59.9 had a 1.90-fold higher risk (&lt;i&gt;P&lt;\/i&gt;&lt;0.01) and those with FLI \u226560 had a 2.94-fold higher risk (&lt;i&gt;P&lt;\/i&gt;&lt;0.01) of developing HCC compared to those with FLI &lt;30. An increase in FLI from &lt;30 to \u226530 resulted in a 2.10-fold higher risk of HCC (&lt;i&gt;P&lt;\/i&gt;&lt;0.01), while a reduction in FLI from \u226530 to &lt;30 led to a 0.64-fold lower risk (&lt;i&gt;P&lt;\/i&gt;=0.03). Protective benefits of FLI reduction took approximately 3 years to manifest.Conclusion: Baseline and dynamic monitoring of FLI effectively identified HCC risk in T2DM patients with non-cirrhotic livers, supporting early detection and intervention.<\/jats:p>","DOI":"10.3803\/enm.2024.2286","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T02:06:57Z","timestamp":1748484417000},"page":"883-892","update-policy":"https:\/\/doi.org\/10.3803\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Fatty Liver Index Dynamics as a Predictor of Hepatocellular Carcinoma in Patients with Type 2 Diabetes Mellitus and Non-Cirrhotic Livers"],"prefix":"10.3803","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-8894","authenticated-orcid":true,"given":"Eun-Hee","family":"Cho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5273-0089","authenticated-orcid":true,"given":"Min Gu","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7244-8849","authenticated-orcid":true,"given":"Chang Hun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinyoung","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha 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Hyun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2119","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-020-00381-6"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28123"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14937"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.09.007"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.06.021"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30858"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2005.12.007"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.12.053"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4085-6"},{"key":"ref10","first-page":"2006","volume-title":"Single non-invasive model to diagnose nonalcoholic fatty liver disease (NAFLD) and non-alcoholic 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disease in a Kenyan population","author":"Lajeunesse-Trempe","year":"2023"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11122233"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-021-01675-y"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0135-6"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(23)00157-7"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.10.065"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.5009\/gnl220357"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-023-10616-8"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i39.11077"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2022.100873"}],"container-title":["Endocrinology and 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