Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: A meta-analysis.
Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: A meta-analysis.
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DOI：
10.1097/md.0000000000008179
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发表时间：
2017-09
期刊：
影响因子：
1.6
通讯作者：
Lai Z
中科院分区：
文献类型：
--
作者：
Dai W;Ye L;Liu A;Wen SW;Deng J;Wu X;Lai Z
非酒精性脂肪性肝病（NAFLD）正在成为全球范围内的公共卫生问题，在2型糖尿病（T2 DM）患者中非常普遍。然而，在T2 DM患者中NAFLD的估计患病率方面，研究之间存在很大差异。因此，本荟萃分析旨在估计T2 DM患者中NAFLD的汇总患病率。使用MeSH检索PubMed、Web of Science、Embase、Chinese National Knowledge Infrastructure和Wanfang的电子数据库，以识别相关研究。由2名研究者独立进行合格性评估和数据提取，并进行荟萃分析以综合数据。使用Cochran Q检验评估杂散性，并使用I2统计量定量。使用Begg和Egger检验评估发表偏倚。进行亚组分析，以确定异质性的可能来源。这项荟萃分析纳入了24项研究，涉及35，599例T2 DM患者，其中20，264例被确定为NAFLD。在符合条件的研究中观察到高度异质性（I2 = 99.0%，P <0.001），报告的患病率范围为29.6%至87.1%。 根据随机效应模型，T2 DM患者中NAFLD的合并患病率为59.67%（95%置信区间：54.31-64.92%）。敏感性低，Begg检验和Egger检验均显示发表偏倚的可能性低。亚组分析表明，T2 DM患者中NAFLD的患病率因性别、肥胖、高血压、血脂异常、冠心病和慢性肾脏疾病而异。本研究中发现的T2 DM患者中NAFLD的合并高患病率显著强调了早期评估NAFLD的必要性以及加强T2 DM患者NAFLD管理的重要性。
Nonalcoholic fatty liver disease (NAFLD) is emerging as a public health issue worldwide and is highly prevalent in patients with type 2 diabetes mellitus (T2DM). However, there was a great disparity across studies in the estimated prevalence of NAFLD in T2DM patients. This meta-analysis, therefore, aimed to estimate the pooled prevalence of NAFLD in T2DM patients. Electronic databases of PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, and Wanfang were searched using MeSH terms to identify relevant studies. Eligibility assessment and data extraction were conducted independently by 2 investigators and a meta-analysis was performed to synthesize the data. Heterogeneity was evaluated using the Cochran Q test and quantified using the I2 statistic. Publication bias was assessed using both the Begg and Egger tests. Subgroup analyses were performed to identify the possible sources of heterogeneity. Twenty-four studies involving 35,599 T2DM patients were included in this meta-analysis, of which 20,264 were identified with NAFLD. A high degree of heterogeneity (I2 = 99.0%, P < .001) was observed among the eligible studies, with the reported prevalence ranging from 29.6% to 87.1%. The pooled prevalence of NAFLD in T2DM patients, by a random-effects model, was 59.67% (95% confidence interval: 54.31–64.92%). Sensitivity was low and both the Begg test and Egger test showed low possibility of publication bias. Subgroup analyses indicated that the prevalence of NAFLD in T2DM patients differed by gender, obesity, hypertension, dyslipidemia, coronary heart disease, and chronic kidney disease. The high pooled prevalence of NAFLD in T2DM patients found in this study significantly underscores the need for early assessment of NAFLD and the importance of strengthening the management of NAFLD in T2DM patients.