One-hour post-load hyperglycemia confers higher risk of hepatic steatosis to HbA1c-defined pre-diabetic subjects

CONTEXT: Individuals with glycated hemoglobin (HbA1c)-defined prediabetes (HbA1c 5.7-6.4%) and 1-hour plasma glucose ≥155 mg/dl during an OGTT have increased risk to develop type 2 diabetes.OBJECTIVE: To evaluate the degree to which HbA1c-defined prediabetes and 1-hour post-load glucose ≥155 mg/dl individually and jointly associate with hepatic steatosis, and related biomarkers.DESIGN AND PATIENTS: A cross-sectional analysis was performed on 1108 White individuals.SETTING: Ambulatory care.MAIN OUTCOME MEASURES: Anthropometric and metabolic characteristics including hepatic steatosis assessed by ultrasonography.RESULTS: Compared with the normal group (HbA1c <5.7%), HbA1c-defined pre-diabetic and diabetic individuals exhibit higher values of fasting, 1-hour and 2-hour post-load glucose, fasting and 2-hour post-load insulin, triglycerides, uric acid, HOMA-IR, liver IR index, liver enzymes, inflammatory biomarkers, and lower high-density lipoprotein (HDL) cholesterol and IGF-1. Pre-diabetic and diabetic subjects have increased risk of hepatic steatosis (1.5-fold and 2.46-fold, respectively). Stratifying participants according to HbA1c and 1-hour post-load glucose, we found that individuals with HbA1c-defined prediabetes and 1-hour post-load glucose ≥155 mg/dl have significantly higher risk of hepatic steatosis as compared with individuals with HbA1c-defined prediabetes but 1-hour post-load glucose <155 mg/dl. Individuals with HbA1c-defined prediabetes and 1-hour post-load glucose ≥155 mg/dl exhibit higher values of liver enzymes, fasting, 1-hour and 2-hour post-load glucose and insulin, triglycerides, uric acid, inflammatory biomarkers, and lower levels of HDL and IGF-1.CONCLUSIONS: These data suggest that a value of 1-hour post-load glucose ≥155 mg/dl may be helpful to identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of hepatic steatosis.