Diabetes, Plasma Glucose, and Incidence of Fatty Liver, Cirrhosis, and Liver Cancer: A Prospective Study of 0.5 Million People.
Diabetes, Plasma Glucose, and Incidence of Fatty Liver, Cirrhosis, and Liver Cancer: A Prospective Study of 0.5 Million People.
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DOI：
10.1002/hep.30083
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发表时间：
2018-10
期刊：
影响因子：
--
通讯作者：
Chen Z
中科院分区：
文献类型：
--
作者：
Pang Y;Kartsonaki C;Turnbull I;Guo Y;Clarke R;Chen Y;Bragg F;Yang L;Bian Z;Millwood IY;Hao J;Han X;Zang Y;Chen J;Li L;Holmes MV;Chen Z
糖尿病的患病率在中国迅速增加。然而，关于其对慢性肝病和肝癌的影响的证据有限。我们研究了中国成年非糖尿病受试者中糖尿病与慢性肝病和肝癌的相关性，以及随机血糖（RPG）与这些肝病的相关性，以及B型肝炎病毒（HBV）感染可能的相互作用。中国嘉道理生物样本库招募了512，891名成年人。在10年的随访期间，在基线时没有癌症或慢性肝病病史的503，993名参与者中记录了2，568例肝癌，2，082例肝硬化，1，298例住院非酒精性脂肪性肝病（NAFLD）和244例住院酒精性肝病（ALD）病例。采用考克斯回归法，根据糖尿病状态（既往诊断或筛查检出）以及既往未诊断糖尿病的患者中的RPG水平，估计每种疾病的风险比（HR）。总体而言，5.8%的参与者在基线时患有糖尿病。与非糖尿病患者相比，糖尿病患者肝癌的校正HR为1.49（95%置信区间1.30 - 1.70），肝硬化为1.81（1.57 - 2.09），NAFLD为1.76（1.47 - 2.16），ALD为2.24（1.42 - 3.54）。过度风险下降，但在那些持续时间较长的人中仍然较高。在既往未诊断为糖尿病的患者中，RPG与肝脏疾病呈正相关，对于肝癌，每升高1 mmol/L RPG的校正HR为1.04（1.03 - 1.06），肝硬化为1.07（1.05 - 1.09），NAFLD为1.07（1.05 - 1.10），ALD为1.10（1.05 - 1.15）。这些关联在HBV感染者之间没有差异。结论：在中国成年人中，糖尿病和无糖尿病的人中较高的血糖水平与肝癌和主要慢性肝病的较高风险相关。
The prevalence of diabetes is increasing rapidly in China. However, evidence is limited about its effects on chronic liver diseases and liver cancer. We examined the associations of diabetes with chronic liver diseases and liver cancer and of random plasma glucose (RPG) with these liver diseases among participants without diabetes in Chinese adults and the possible interaction by hepatitis B virus (HBV) infection. The prospective China Kadoorie Biobank recruited 512,891 adults. During 10 years of follow‐up, 2,568 liver cancer, 2,082 cirrhosis, 1,298 hospitalized nonalcoholic fatty liver disease (NAFLD), and 244 hospitalized alcoholic liver disease (ALD) cases were recorded among 503,993 participants without prior history of cancer or chronic liver diseases at baseline. Cox regression was used to estimate hazard ratios (HRs) for each disease by diabetes status (previously diagnosed or screen‐detected) and, among those without previously diagnosed diabetes, by levels of RPG. Overall 5.8% of participants had diabetes at baseline. Compared to those without diabetes, individuals with diabetes had adjusted HRs of 1.49 (95% confidence interval 1.30‐1.70) for liver cancer, 1.81 (1.57‐2.09) for cirrhosis, 1.76 (1.47‐2.16) for NAFLD, and 2.24 (1.42‐3.54) for ALD. The excess risks decreased but remained elevated in those with longer duration. Among those without previously diagnosed diabetes, RPG was positively associated with liver diseases, with adjusted HRs per 1 mmol/L higher RPG of 1.04 (1.03‐1.06) for liver cancer, 1.07 (1.05‐1.09) for cirrhosis, 1.07 (1.05‐1.10) for NAFLD, and 1.10 (1.05‐1.15) for ALD. These associations did not differ by HBV infection. Conclusion: In Chinese adults, diabetes and higher blood glucose levels among those without known diabetes are associated with higher risks of liver cancer and major chronic liver diseases.
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影响因子：
3.7
作者：
Li Y;Wang J;Tang Y;Han X;Liu B;Hu H;Li X;Yang K;Yuan J;Miao X;Yao P;Wei S;Wang Y;Liang Y;Zhang X;Guo H;Pan A;Yang H;Hu FB;Wu T;He M
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作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
--
作者：
Han H;Zhang T;Jin Z;Guo H;Wei X;Liu Y;Chen Q;He J
通讯作者：
He J
DOI：
10.1111/dme.12392
发表时间：
2014-05
期刊：
Diabetic medicine : a journal of the British Diabetic Association
影响因子：
--
作者：
Bragg F;Li L;Smith M;Guo Y;Chen Y;Millwood I;Bian Z;Walters R;Chen J;Yang L;Collins R;Peto R;Lu Y;Yu B;Xie X;Lei Y;Luo G;Chen Z;China Kadoorie Biobank Collaborative Group
通讯作者：
China Kadoorie Biobank Collaborative Group