Lean non-alcoholic fatty liver disease and risk of incident diabetes in a euglycaemic population undergoing health check-ups: A cohort study
Lean non-alcoholic fatty liver disease and risk of incident diabetes in a euglycaemic population undergoing health check-ups: A cohort study
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接受健康检查的血糖正常人群的瘦非酒精性脂肪肝和糖尿病发生风险：一项队列研究
DOI：
10.1016/j.diabet.2020.08.008
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发表时间：
2021-05-01
影响因子：
7.2
通讯作者：
Chen, Lei
中科院分区：
文献类型：
--
作者：
Wei, Limin;Cheng, Xin;Chen, Lei
导论. - 令人信服的证据表明，非酒精性脂肪肝（NAFLD）与胰岛素抵抗和糖尿病风险增加有关;然而，瘦NAFLD与糖尿病发病之间的关联，特别是性别差异，迄今尚未报道。因此，本研究旨在调查瘦NAFLD和超重/肥胖NAFLD是否在两种性别中赋予新发糖尿病相同的额外风险。- 我们的纵向研究在14，482名参加健康检查计划的正常人中进行。经腹部超声诊断为脂肪肝。关注的结果是糖尿病事件。- 在平均6.0年的随访中，诊断出356例糖尿病。在调整社会人口统计学和其他潜在混杂因素后，在整个队列中，瘦型NAFLD患者与瘦型非NAFLD患者发生糖尿病的完全校正HR（95% CI）为2.58（95% CI：1.68-3.97）。女性和男性的相应HR分别为5.53（95% CI：2.30-13.30）和2.02（95% CI：1.24-3.31）。事后分析显示，无论是在整个研究人群还是按性别分层的亚组中，瘦型和超重/肥胖型NAFLD组发生糖尿病的相对风险相似（均P > 0. 05）。- 瘦NAFLD确实是两种性别中发生2型糖尿病的危险因素，尽管这种影响在女性中比男性更明显。现在需要进一步的调查，以获得更好的理解NAFLD的自然历史，在瘦的科目。(C)2020 Elsevier Masson SAS。All rights reserved.
Introduction. - Convincing evidence suggests that non-alcoholic fatty liver disease (NAFLD) is associated with insulin resistance and an increased risk of diabetes; however, the association between lean NAFLD and incident diabetes, and especially differences according to gender, have not been reported thus far. This study therefore aimed to investigate whether lean NAFLD and overweight/obese NAFLD confer the same excess risk of new-onset diabetes in both genders.Methods. - Our longitudinal study was performed in 14,482 euglycaemic adults who had participated in a health checkup programme. Fatty liver was diagnosed by abdominal ultrasonography. The outcome of interest was incident diabetes.Results. - Over the median 6.0 years of follow-up, 356 cases of diabetes were diagnosed. After adjusting for sociodemographic and other potential confounders, the fully adjusted HR (95% CI) for incident diabetes in lean NAFLD vs lean without NAFLD patients was 2.58 (95% CI: 1.68-3.97) in the total cohort. Corresponding HRs were 5.53 (95% CI: 2.30-13.30) and 2.02 (95% CI: 1.24-3.31) for women and men, respectively. Post-hoc analysis revealed that the relative risk for developing diabetes was similar between lean and overweight/obese NAFLD groups whether in the entire study population or in subgroups stratified by gender (all P > 0.05).Conclusion. - Lean NAFLD is indeed a risk factor for incident type 2 diabetes in both genders, although the effect appeared to be more pronounced in women than in men. Further investigations are now needed to obtain a better understanding of the natural history of NAFLD in lean subjects. (C) 2020 Elsevier Masson SAS. All rights reserved.