{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:58:47Z","timestamp":1790852327503,"version":"4.1.0"},"posted":{"date-parts":[[2026,9,28]]},"group-title":"Epidemiology","reference-count":27,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"award":["R01DK129305"],"award-info":[{"award-number":["R01DK129305"]}],"id":[{"id":"https:\/\/ror.org\/00adh9b73","id-type":"ROR","asserted-by":"publisher"}]},{"award":["5K23DK113252"],"award-info":[{"award-number":["5K23DK113252"]}],"id":[{"id":"https:\/\/ror.org\/00adh9b73","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01HL156975"],"award-info":[{"award-number":["R01HL156975"]}],"id":[{"id":"https:\/\/ror.org\/023ny1p48","id-type":"ROR","asserted-by":"publisher"}]},{"award":["N01-HC25195"],"award-info":[{"award-number":["N01-HC25195"]}],"id":[{"id":"https:\/\/ror.org\/023ny1p48","id-type":"ROR","asserted-by":"publisher"}]},{"award":["HHSN268201500001I"],"award-info":[{"award-number":["HHSN268201500001I"]}],"id":[{"id":"https:\/\/ror.org\/023ny1p48","id-type":"ROR","asserted-by":"publisher"}]},{"award":["75N92019D00031"],"award-info":[{"award-number":["75N92019D00031"]}],"id":[{"id":"https:\/\/ror.org\/023ny1p48","id-type":"ROR","asserted-by":"publisher"}]},{"award":["26PRE1564902"],"award-info":[{"award-number":["26PRE1564902"]}],"id":[{"id":"https:\/\/ror.org\/013kjyp64","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background &amp; Aims<\/jats:title>\n                  <jats:p>Dysglycemia is associated with increased risk for hepatic features, including steatosis and fibrosis. Yet, the associations of dynamic measures of glycemia with hepatic features among individuals without diabetes remain understudied.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included participants from the Framingham Heart Study (FHS) Third Generation cohorts without diabetes who underwent assessment for hepatic steatosis (controlled attenuation parameter [CAP]) and fibrosis (liver stiffness measurement ([LSM]), using vibration-controlled transient elastography, had \u22653 days of continuous glucose monitor data (blinded Dexcom G6 Pro CGM) and completed a mixed meal tolerance test, containing a total of 600 kcal, 75 g carbohydrate, 21 g fat, and 29 g protein (MMTT, 2022-2025). We performed multivariable linear and logistic regression to investigate the associations of standardized 2-h postprandial glucose (2-h PPG) following MMTT, as well as CGM-derived measures, with CAP and log-transformed LSM, as well as hepatic steatosis (CAP\u2265274ndB\/m) and fibrosis (LSM\u22658.2 kPa), adjusting for confounders.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    In 1071 FHS participants (58.3% female, 56.4% normoglycemia), mean age was 60.2 years and BMI 28.2 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    . Higher 2-h MMTT-PPG and CGM summary measures of glycemic burden (e.g., % time &gt;140 mg\/dL) were associated with 23-36% higher odds of steatosis and higher CAP. Similarly, CGM summary measures of glycemic burden (e.g., % time &gt;140 mg\/dL) and glycemic variability (e.g., coefficient of variation) were associated with 28-59% higher odds of hepatic fibrosis but not log-LSM.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Measures of postprandial and continuous glucose dynamics are associated with hepatic features among individuals without diabetes.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.25.26364009","type":"posted-content","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:40:16Z","timestamp":1790628016000},"source":"Crossref","is-referenced-by-count":0,"title":["Dynamic Measures of Glycemia in Relation to Hepatic Features in Adults Without Diabetes"],"prefix":"10.64898","author":[{"given":"Bahar","family":"Bakhshi","sequence":"first","affiliation":[{"name":"Section of Preventive Medicine & Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naznin","family":"Sultana","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health (BUSPH), Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Nayor","sequence":"additional","affiliation":[{"name":"Section of Preventive Medicine & Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"},{"name":"Section of Cardiovascular Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghuang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, 01655, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiantao","family":"Ma","sequence":"additional","affiliation":[{"name":"Tufts University Friedman School of Nutrition Science and Policy, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin W.","family":"Steenkamp","sequence":"additional","affiliation":[{"name":"Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian and Avedisian School of Medicine (BUCASM) and Boston Medical Center, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle T.","family":"Long","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S, Vandt\u00e5rnsvej 108-110 S\u00f8borg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole L.","family":"Spartano","sequence":"additional","affiliation":[{"name":"Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian and Avedisian School of Medicine (BUCASM) and Boston Medical Center, Boston, MA 02118, USA"},{"name":"Boston University\u2019s and National Heart, Lung, and Blood Institute\u2019s Framingham Heart Study, Framingham, MA 01702, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura E.","family":"Walker","sequence":"additional","affiliation":[{"name":"Section of Preventive Medicine & Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA"},{"name":"Boston University\u2019s and National Heart, Lung, and Blood Institute\u2019s Framingham Heart Study, Framingham, MA 01702, USA"},{"name":"Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026100103301163000_2026.09.25.26364009v1.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2412865"},{"key":"2026100103301163000_2026.09.25.26364009v1.2","doi-asserted-by":"publisher","DOI":"10.2337\/dci24-0094"},{"issue":"4","key":"2026100103301163000_2026.09.25.26364009v1.3","first-page":"226","article-title":"Clusters of metabolic dysfunction-associated steatotic liver disease for precision medicine","volume":"22","year":"2025","journal-title":"Nature Reviews Gastroenterology & Hepatology"},{"key":"2026100103301163000_2026.09.25.26364009v1.4","doi-asserted-by":"crossref","unstructured":"Xie S , Merino J . 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