Non-alcoholic fatty liver disease associated with increased arterial stiffness in subjects with normal glucose tolerance, but not pre-diabetes and diabetes

Aim: To evaluate the association between non-alcoholic fatty liver disease and arterial stiffness in adults with normal glucose tolerance, pre-diabetes and newly diagnosed diabetes after excluding known diabetes. Methods: A total of 4860 subjects were divided into normal glucose tolerance, pre-diabetes and newly diagnosed diabetes groups according to the American Diabetes Association 2011 diagnostic criteria. The severity of non-alcoholic fatty liver disease was divided into mild and moderate to severe. Increased arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV)>= 1400cm/s. Results: There was a significant difference in the prevalence of mild and moderate to severe non-alcoholic fatty liver disease between subjects with and without increased arterial stiffness. Mild (odds ratio (OR)=2.02, 95% confidence interval (CI)=1.43-2.84) and moderate to severe (OR=2.15, 95% CI=1.33-3.46) non-alcoholic fatty liver disease were independently associated with increased arterial stiffness in the normal glucose tolerance group. In the pre-diabetes and diabetes groups, neither mild nor moderate to severe non-alcoholic fatty liver disease was associated with increased arterial stiffness. Conclusion: The effect of non-alcoholic fatty liver disease on arterial stiffness is apparent in subjects with normal glucose tolerance, but not in diabetes and pre-diabetes.