Non-alcoholic fatty liver disease in diabetics - prevalence and predictive factors in a multiracial hospital clinic population in Malaysia
Non-alcoholic fatty liver disease in diabetics - prevalence and predictive factors in a multiracial hospital clinic population in Malaysia
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DOI：
10.1111/jgh.12204
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发表时间：
2013-08-01
影响因子：
4.1
通讯作者：
Goh, Khean-Lee
中科院分区：
文献类型：
--
作者：
Chan, Wah-Kheong;Tan, Alexander Tong-Boon;Goh, Khean-Lee
背景和目的：亚太地区不同种族糖尿病患者中非酒精性脂肪性肝病(NAFLD)的患病率及其相关因素的比较研究目前尚无公开发表的研究。全球体力活动问卷和半定量食物频率问卷分别用于评估体力活动和膳食摄入量。结果：分析了399例患者的数据(平均年龄62.3+/-10.5岁，43.1%的男性)。华裔占43.6%，印度裔占33.1%，马来族占22.3%，其他占1.0%。NAFLD患病率为49.6%。单因素分析显示，与NAFLD相关的因素有年龄65岁、种族、肥胖、中心性肥胖、糖化血红蛋白=7.0%、血清丙氨酸氨基转移酶(ALT)和γ-谷氨酰转肽酶水平升高。体力活动少的患者更易患非酒精性脂肪肝(优势比[OR]=1.6 7，95%可信区间[CI]=1.0 6~2.6 3，P=0.020)。非酒精性脂肪肝的患病率在马来人中最高(60.7%)，其次是印度人(51.5%)，在中国人中最低(42.0%)，这与前几组患者中中心性肥胖的患病率和从脂肪中摄取的卡路里比例较高一致。多因素分析显示，中心性肥胖(OR=2.2 0，95%CI=1.2 9~3.75，P=0.004)和血清ALT水平升高(OR=1.98，95%CI=1.2 1~3.2 5，P=0.007)是NAFLD的独立危险因素。非酒精性脂肪肝的患病率在不同种族之间是不同的，并且与中心性肥胖症的患病率和脂肪摄入卡路里的百分比的差异是平行的。
Background and Aim: There is currently no published study comparing prevalence of non-alcoholic fatty liver disease (NAFLD) and associated factors among diabetics of different ethnicity in the Asia-Pacific region.Methods: Cross-sectional study of consecutive patients in the Diabetic Clinic in University of Malaya Medical Centre. The Global Physical Activity Questionnaire and a semi-quantitative food-frequency questionnaire were used to assess physical activity and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake.Results: Data for 399 patients were analyzed (mean age 62.3 +/- 10.5 years, 43.1% men). The racial distribution was Chinese 43.6%, Indian 33.1%, Malay 22.3%, and others 1.0%. The prevalence of NAFLD was 49.6%. On univariate analysis, factors associated with NAFLD were age < 65 years, race, obesity, central obesity, glycated hemoglobin >= 7.0%, and elevated serum alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase levels. Patients with low physical activity were more likely to have NAFLD (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.06-2.63, P = 0.020). The prevalence of NAFLD was highest among Malays (60.7%), followed by Indians (51.5%), and lowest among Chinese (42.0%) consistent with higher prevalence of central obesity and higher percentage calorie intake from fat in the former groups of patients. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR = 2.20, 95% CI = 1.29-3.75, P = 0.004) and elevated serum ALT level (OR = 1.98, 95% CI = 1.21-3.25, P = 0.007).Conclusions: NAFLD was seen in half of a cohort of diabetic patients and was independently associated with central obesity and elevated serum ALT level. Prevalence of NAFLD was different and paralleled the difference in prevalence of central obesity and in percentage calorie intake from fat among the different ethnic groups.