Impaired Glucagon Suppression Accompanied by Liver Fat Accumulation Mediated Worse Blood Glucose Control in Patients With T2D
Authors' conclusion
Liver fat accumulation in T2D is strongly associated with defective postprandial glucagon suppression, particularly in males, which mediates nearly one-third of its detrimental impact on glycemic control. Targeting hepatic steatosis and glucagon signaling may offer novel therapeutic strategies for T2D management.
Study context
- Population
- Patients with T2D undergoing liver fat quantification (FibroScan controlled attenuation parameter (CAP) and liver US) and 180-minute oral glucose tolerance tests (OGTTs); Continuous glucose monitoring (CGM) in 287CGM in 287
- Participants
- 604 patients
- Exposure
- T2D with MASLD vs without MASLD
- MASLDn = 414
- non-MASLDn = 190reference
- Outcome
- Glucagon suppression during OGTT (early, late and overall phases)
Main finding
As reported in the abstract
Each 1-SD CAP increase independently predicted attenuated suppression in all phases (standardized β)
0.183-0.303
P < .001
Glucagon suppression mediated share of adverse effects of liver fat on hyperglycemia
14.9% to 33.9%
Observational data: associations, not effects.
Further findings
Sex differences
- Males showed greater suppression impairment than females and stronger CAP-associated dysregulation
Original publication
Impaired Glucagon Suppression Accompanied by Liver Fat Accumulation Mediated Worse Blood Glucose Control in Patients With T2D. J Clin Endocrinol Metab. Published 23 May 2025. doi:10.
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