Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: a meta-analysis
Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: a meta-analysis
复制标题
DOI：
10.1097/meg.0000000000001075
复制
发表时间：
2018-06-01
影响因子：
2.1
通讯作者：
Zheng, Ming-Hua
中科院分区：
文献类型：
--
作者：
Zhou, Yao-Yao;Zhou, Xiao-Dong;Zheng, Ming-Hua
背景：非酒精性脂肪性肝病（NAFLD）与心血管疾病（CVD）风险增加有关。为了探讨糖尿病（DM）作为心血管危险因素的影响，本荟萃分析定量评估了糖尿病患者NAFLD和CVD的相关性。方法截至2017年3月底，对PubMed、EMBASE和Cochrane Library数据库进行分析。纳入了分析糖尿病人群中NAFLD与心血管危险因素之间关系的原始研究。提取与结果相关的可用数据，使用随机效应模型进行效果估计。纳入研究的质量采用纽卡斯尔-渥太华质量评估量表进行评估。在最初纳入的770项研究中，最终纳入了11项研究，涉及8346名患者。纽卡斯尔-渥太华质量评估量表得分表明纳入的研究具有高质量。合并效应估计显示，合并NAFLD的糖尿病患者发生心血管疾病的风险是未合并NAFLD患者的两倍（优势比= 2.20,95%可信区间：1.67-2.90）。亚组分析也显示风险显著增加，横断面研究和队列研究的比值比（95%置信区间）分别为2.28（1.61-3.23）和1.90（1.48-2.45）。这是第一个独立于糖尿病影响的调查NAFLD和CVD之间关系的荟萃分析。我们的研究结果表明，NAFLD增加了具有可比糖尿病概况的人群中CVD的风险。诊断为NAFLD的糖尿病患者可能受益于更早的心血管风险评估，从而降低心血管疾病的发病率和死亡率。版权所有2018威科集团有限公司版权所有。
Background Nonalcoholic fatty liver disease (NAFLD) has been linked to an increased risk of cardiovascular disease (CVD). To explore the impact of diabetes mellitus (DM) as a cardiovascular risk factor, this meta-analysis quantitatively assessed the association of NAFLD and CVD in diabetic patients.Methods PubMed, EMBASE, and the Cochrane Library database were analyzed until the end of March 2017. Original studies analyzing the association between NAFLD and cardiovascular risk factors in the diabetic population were included. The available data related to outcome were extracted for the effect estimate using a random-effects model. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale.Results Of the 770 initially identified studies, 11 studies involving 8346 patients were finally included. The Newcastle-Ottawa Quality Assessment Scale scores suggested that the studies included were of high quality. The pooled effects estimate showed that diabetic patients with NAFLD showed a two times increased risk for CVD compared with patients without NAFLD (odds ratio = 2.20, 95% confidence interval: 1.67-2.90). Subgroup analysis also yielded a markedly increased risk, with odds ratio (95% confidence interval) values of 2.28 (1.61-3.23) and 1.90 (1.48-2.45) in cross-sectional and cohort studies, respectively.Conclusion This is the first meta-analysis investigating the relationship between NAFLD and CVD independent of the impact of DM. Our findings suggested that NAFLD increases the risk of CVD in populations with comparable DM profiles. Diabetic patients diagnosed with NAFLD might benefit from a more early cardiovascular risk assessment, thereby reducing CVD morbidity and mortality. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.