Nine-year incident diabetes is predicted by fatty liver indices: the French DESIR study
Nine-year incident diabetes is predicted by fatty liver indices: the French DESIR study
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DOI：
10.1186/1471-230x-10-56
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发表时间：
2010-06-07
影响因子：
2.4
通讯作者：
Bonnet, Fabrice
中科院分区：
文献类型：
--
作者：
Balkau, Beverley;Lange, Celine;Bonnet, Fabrice
背景：脂肪肝与胰岛素抵抗、酒精摄入、糖尿病和肥胖有关。在临床实践中，活检甚至扫描评估脂肪肝并不总是可行的。本报告评估了两个最近发表的脂肪肝标志物的预测能力：脂肪肝指数（FLI）和NAFLD脂肪肝评分法国普通人群队列中9年新发糖尿病的NAFLD-FLS：来自胰岛素抵抗综合征流行病学研究的数据方法：在基线时，有1861名男性和1950名女性，非糖尿病，年龄30至65岁。在随访中，203例糖尿病患者（140例男性，63例女性）通过糖尿病治疗或空腹血糖≥ 7.0 mmol/l确定。FLI包括：BMI、腰围、甘油三酯和γ谷氨酰转移酶以及NAFLD-FLS：代谢综合征、糖尿病、胰岛素、丙氨酸氨基转移酶和天冬氨酸氨基转移酶。Logistic回归分析用于确定与脂肪肝指数类别相关的糖尿病事件的比值比。结果：与FLI < 20的患者相比，FLI >= 70的糖尿病（95%置信区间）为9.33（5.05-17.25）和36.72（17.12-78.76）妇女;这些衰减到3.43（1.61-7.28）和11.05（4.09 29.81），调整基线血糖、胰岛素、高血压、饮酒、体力活动、吸烟和糖尿病家族史后;而不过量饮酒者的优势比分别为4.71（1.68-13.16）和22.77（6.78-76.44）。非酒精性脂肪肝-FLS也预测糖尿病事件，但比值比低得多的妇女，类似的男性。结论：这些脂肪肝指数是简单的临床工具，用于评估肝脏脂肪的程度，他们是预测糖尿病事件。脂肪肝患者有哪些症状？
Background: Fatty liver is known to be linked with insulin resistance, alcohol intake, diabetes and obesity. Biopsy and even scan-assessed fatty liver are not always feasible in clinical practice. This report evaluates the predictive ability of two recently published markers of fatty liver: the Fatty Liver Index (FLI) and the NAFLD fatty liver score (NAFLD-FLS), for 9-year incident diabetes, in the French general-population cohort: Data from an Epidemiological Study on the Insulin Resistance syndrome (D.E.S.I.R).Methods: At baseline, there were 1861 men and 1950 women, non-diabetic, aged 30 to 65 years. Over the follow-up, 203 incident diabetes cases (140 men, 63 women) were identified by diabetes-treatment or fasting plasma glucose >= 7.0 mmol/l. The FLI includes: BMI, waist circumference, triglycerides and gamma glutamyl transferase, and the NAFLD-FLS: the metabolic syndrome, diabetes, insulin, alanine aminotransferase, and asparate aminotransferase. Logistic regression was used to determine the odds ratios for incident diabetes associated with categories of the fatty liver indices.Results: In comparison to those with a FLI < 20, the age-adjusted odds ratio (95% confidence interval) for diabetes for a FLI >= 70 was 9.33 (5.05-17.25) for men and 36.72 (17.12-78.76) for women; these were attenuated to 3.43 (1.61-7.28) and 11.05 (4.09 29.81), after adjusting on baseline glucose, insulin, hypertension, alcohol intake, physical activity, smoking and family antecedents of diabetes; odds ratios increased to 4.71 (1.68-13.16) and 22.77 (6.78-76.44) in those without an excessive alcohol intake. The NAFLD-FLS also predicted incident diabetes, but with odds ratios much lower in women, similar in men.Conclusions: These fatty liver indexes are simple clinical tools for evaluating the extent of liver fat and they are predictive of incident diabetes. Physicians should screen for diabetes in patients with fatty liver.