GA/HbA1c ratio is a simple and practical indicator to evaluate the risk of metabolic dysfunction-associated fatty liver disease in type 2 diabetes: an observational study

• Published in: Diabetology and metabolic syndrome Vol. 14; no. 1; pp. 1 - 167
• Main Authors: Wang, Jun-Wei, Jin, Chun-Hua, Ke, Jiang-Feng, Ma, Yi-Lin, Wang, Yu-Jie, Lu, Jun-Xi, Li, Mei-Fang, Li, Lian-Xi
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 11.11.2022; BioMed Central; BMC
• Subjects: Abdomen; Age; Alcohol; Blood pressure; Body mass index; Cholesterol; Diabetes; Diabetes mellitus (non-insulin dependent); Diagnosis; Diagnostic imaging; Fatty liver; GA/HbA1C ratio; Gender; Glucose; Glycated albumin/glycated hemoglobin A1C; Glycosylated hemoglobin; Hemoglobin; Hypertension; Insulin; Insulin resistance; Laboratories; Liver diseases; Medical research; Medicine, Experimental; Metabolic disorders; Metabolic dysfunction-associated fatty liver disease; Non-alcoholic fatty liver disease; Obesity; Observational studies; Patients; Peptides; Regression analysis; Type 2 diabetes; Type 2 diabetes mellitus
• ISSN: 1758-5996; 1758-5996
• DOI: 10.1186/s13098-022-00946-2

Background It is still debatable whether glycated albumin/glycated hemoglobin A1C (GA/HbA1C) ratio is associated with metabolic dysfunction-associated fatty liver disease (MAFLD), and few studies have been conducted in type 2 diabetes mellitus (T2DM). Therefore, we aimed to investigate the association between GA/HbA1C ratio and MAFLD and to evaluate whether GA/HbA1C ratio can be used an indicator of MAFLD in Chinese patients with T2DM. Methods This cross-sectional study consisted of 7117 T2DM patients including 3296 men and 3821 women from real-world settings. Abdominal ultrasonography was performed to diagnose MAFLD. In addition to comparing the clinical characteristics among the GA/HbA1C ratio quartile groups, we also investigated the associations of GA/HbA1C ratio and quartiles with MAFLD in T2DM subjects. Results There was a significantly decreased trend in the MAFLD prevalence across the GA/HbA1C ratio quartiles (56.3%, 47.4%, 37.8%, and 35.6% for the first, second, third, and fourth quartile, respectively, P < 0.001 for trend) after adjusting for gender, age, and diabetes duration. Fully adjusted Binary logistic regression indicated that both GA/HbA1C ratio (OR: 0.575, 95% CI: 0.471 to 0.702, P < 0.001) and quartiles (P < 0.001 for trend) were inversely associated with the presence of MAFLD among T2DM patients. Additionally, HOMA2-IR values were clearly increased in the T2DM subjects with MAFLD compared with those without MAFLD (P < 0.001), and markedly increased from the highest to the lowest GA/HbA1C ratio quartile (P < 0.001 for trend). Conclusions GA/HbA1C ratio is closely and negatively associated with MAFLD in T2DM subjects, which may attribute to that GA/HbA1C ratio reflects the degree of insulin resistance. GA/HbA1C ratio may act as a simple and practical indicator to evaluate the risk of MAFLD in T2DM. Keywords: Glycated albumin/glycated hemoglobin A1C, GA/HbA1C ratio, Metabolic dysfunction-associated fatty liver disease, Non-alcoholic fatty liver disease, Insulin resistance, Type 2 diabetes mellitus