Non-alcoholic fatty liver disease is associated with late but not early atherosclerotic lesions in Chinese inpatients with type 2 diabetes
Non-alcoholic fatty liver disease is associated with late but not early atherosclerotic lesions in Chinese inpatients with type 2 diabetes
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DOI：
10.1016/j.jdiacomp.2016.09.008
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发表时间：
2017-01-01
影响因子：
3
通讯作者：
Jia, Weiping
中科院分区：
文献类型：
--
作者：
Guo, Kaifeng;Zhang, Lei;Jia, Weiping
目的：目的探讨非酒精性脂肪肝（NAFLD）与颈动脉和下肢动脉粥样硬化病变之间的关系，并评估中国2型糖尿病（T2 DM）患者NAFLD的患病率和特征。方法：本横断面研究共纳入8571例T2 DM患者（4804例男性）。主要观察指标为NAFLD、颈动脉内膜中层厚度（C-IMT）、颈动脉和下肢动脉粥样硬化斑块形成以及经典危险因素。（56.5% vs. 445%; p < 0.001）和下肢斑块（562% vs. 48.7%; p < 0.001），颈动脉（112% vs. 6.8%; p < 0.001）和下肢狭窄在控制了年龄因素后，伴NAFLD的糖尿病患者的血清总胆固醇水平（15.1%对10.3%; p < 0.001）明显高于不伴NAFLD的糖尿病患者。然而，在控制饲料后，伴和不伴NAFLD的糖尿病患者之间的C-IMT无显著差异（0.82 +/-0.30 mm vs. 0.85 +/- 0.39 mm）。完全校正的多元线性回归和logistic回归分析显示，NAFLD与颈动脉和下肢动脉粥样硬化斑块的患病率增加显著相关，但与C-IMT无关。结论：在中国住院T2 DM患者中，NAFLD与C-IMT升高无关，但与颈动脉和下肢动脉粥样硬化斑块的发生相关，与传统心血管危险因素和代谢综合征无关。(C)2017爱思唯尔公司All rights reserved.
Aims: To investigate the association between non-alcoholic fatty liver disease (NAFLD) and carotid and lower limb atherosclerotic lesions in a large group of hospitalized-based type 2 diabetic population and to assess the prevalence and characteristics of NAFLD in Chinese subjects with type 2 diabetes (T2DM).Methods: A total of 8571 patients (4804 men) with T2DM were included in this cross-sectional study. The main outcome measures were detection of NAFLD, carotid intima-media thickness (C-IMT), carotid and lower limb atherosclerotic plaque formation, and classical risk factors.Results: The prevalence of carotid (56.5% vs. 445%; p < 0.001) and lower limb plaque (562% vs. 48.7%; p < 0.001), and carotid (112% vs. 6.8%; p < 0.001) and lower limb stenosis (15.1% vs. 10.3%; p < 0.001) was markedly higher in the diabetic patients with NAFLD than in those without, after controlling for age. However, there was no significant difference in C-IMT between diabetic patients with and without NAFLD (0.82 +/- 030 mm vs. 0,85 +/- 0.39 mm) after controlling forage. Fully adjusted multiple linear regression and logistic regression analyses revealed that NAFLD was significantly associated with increased prevalence of carotid and lower limb atherosclerotic plaque but not with C-IMT. NAFLD, age, sex, longer duration of diabetes and the presence of hypertension were independently associated with carotid and lower limb atherosclerotic plaque (p < 0.05).Conclusion: NAFLD was not associated with elevated C-IMT but was associated with carotid and lower limb atherosclerotic plaque independent of conventional cardiovascular disease risk factors and metabolic syndrome in Chinese inpatients with T2DM. (C) 2017 Elsevier Inc. All rights reserved.