Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes
Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes
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DOI：
10.1016/j.jhep.2010.04.030
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发表时间：
2010-10-01
影响因子：
25.7
通讯作者：
Bonora, Enzo
中科院分区：
文献类型：
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作者：
Targher, Giovanni;Bertolini, Lorenzo;Bonora, Enzo
背景与目的：评估非酒精性脂肪性肝病（NAFLD）在1型糖尿病患者中的患病率，并评估NAFLD是否与心血管疾病（CVD）患病率增加相关。方法：所有有肝脏超声资料的1型糖尿病患者（n = 250），定期到我们的糖尿病诊所就诊。主要研究措施是NAFLD（通过患者病史和肝脏超声）和无症状/症状性CVD（通过患者病史、图表复习、心电图、颈动脉和下肢动脉超声多普勒扫描）的检测。结果：NAFLD的患病率为44.4%，超声检查显示NAFLD是肝脏脂肪变性的最常见原因（69.8%）。NAFLD患者冠状动脉疾病（10.8% vs. 1.1%）、脑血管疾病（37.3% vs. 5.5%）和外周血管疾病（24.5% vs. 2.5%）的年龄和性别调整患病率明显高于非NAFLD患者（p < 0.001）。在logistic回归分析中，NAFLD与CVD患病率相关（作为复合终点），独立于年龄、性别、糖尿病病程、血红蛋白A（1c）、吸烟史、收缩压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯和药物使用（校正优势比7.36,95%可信区间1.60-34.3,p < 0.01）。结论：我们的研究结果表明，NAFLD在1型糖尿病患者中非常常见，并且与CVD的高患病率相关，独立于几个混杂因素。未来的前瞻性研究需要评估NAFLD是否能预测1型糖尿病的心血管事件。(C) 2010年欧洲肝脏研究协会。Elsevier B.V.版权所有。
Background & Aims: To estimate the prevalence of non-alcoholic fatty liver disease (NAFLD) in type 1 diabetic individuals, and to evaluate whether NAFLD is associated with increased prevalence of cardiovascular disease (CVD).Methods: All patients with diagnosed type 1 diabetes with available liver ultrasound data (n = 250), who regularly attended our diabetes clinic, were enrolled. Main study measures were detection of NAFLD (by patient history and liver ultrasound) and asymptomatic/symptomatic CVD (by patient history, chart review, electrocardiogram, and echo-Doppler scanning of carotid and lower limb arteries).Results: The prevalence of NAFLD was 44.4%, and NAFLD was the most common cause (69.8%) of hepatic steatosis on ultrasound examination. Patients with NAFLD had a remarkably higher (p < 0.001) age- and sex-adjusted prevalence of coronary (10.8% vs. 1.1%), cerebrovascular (37.3% vs. 5.5%) and peripheral (24.5% vs. 2.5%) vascular disease than their counterparts without NAFLD. In logistic regression analysis, NAFLD was associated with prevalent CVD (as composite endpoint), independently of age, sex, diabetes duration, hemoglobin A(1c), smoking history, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and medication use (adjusted odds ratio 7.36, 95% confidence intervals 1.60-34.3, p < 0.01).Conclusions: Our findings suggest that NAFLD is very common in type 1 diabetic subjects and is associated, independently of several confounding factors, with a higher prevalence of CVD. Future prospective studies are needed to evaluate whether NAFLD predicts incident CVD events in type 1 diabetes. (C) 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.