Bidirectional association between nonalcoholic fatty liver disease and type 2 diabetes in Chinese population: Evidence from the Dongfeng-Tongji cohort study.
Bidirectional association between nonalcoholic fatty liver disease and type 2 diabetes in Chinese population: Evidence from the Dongfeng-Tongji cohort study.
复制标题
中国人群非酒精性脂肪肝与2型糖尿病之间的双向关联：来自东风-同济队列研究的证据
DOI：
10.1371/journal.pone.0174291
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
He M
中科院分区：
文献类型：
--
作者：
Li Y;Wang J;Tang Y;Han X;Liu B;Hu H;Li X;Yang K;Yuan J;Miao X;Yao P;Wei S;Wang Y;Liang Y;Zhang X;Guo H;Pan A;Yang H;Hu FB;Wu T;He M
目的探讨非酒精性脂肪性肝病(NAFLD)与2型糖尿病(T2 DM)的双向关系。方法数据来源于东风-同济队列研究，该研究于2008年建立，追踪至2013年10月。根据超声检查将NAFLD分为无、轻、中、重度四种类型。研究NAFLD与T2 DM发病风险之间关系的分析包括18,111名基线时无糖尿病的参与者，随访时间为4.60±0.60年。用COX比例回归模型计算关联的危险比(HR)。这项调查T2 DM与NAFLD发病风险之间关系的分析包括12,435名基线时没有NAFLD的参与者。应用Logistic回归模型计算NAFLD的优势比(OR)。结果与非NAFLD组相比，轻、中、重度NAFLD组与非NAFLD组相比，发生T2 DM的危险性单调增加(HR分别为1.88[95%CI：1.63~2.18]和2.34[1.85~2.96])。在一项平行分析中，与空腹血糖水平为6.1 mmol/L的受试者相比，空腹血糖受损者和T2 DM受试者发生非酒精性脂肪肝的OR值分别为1.35(95%CI：1.16~1.57)和1.40(95%CI：1.22~1.62)。结论我们的研究结果为NAFLD-T2 DM在中国人群中的双向关联提供了有力的证据。
Objectives The aim of this study is to examine the bidirectional association between nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods The data was derived from the Dongfeng-Tongji cohort study, which was established in 2008 and followed until October 2013. NAFLD was classified as none, mild, moderate/severe based on ultrasound examination. The analysis to examine the association between NAFLD and incident T2DM risk included 18,111 participants free of diabetes at baseline and the duration of follow-up was 4.60 ± 0.60 years. Cox proportional regression model was used to calculate the hazard ratio (HR) for the association. The analysis to investigate the association between T2DM and incident NAFLD risk included 12,435 participants free of NAFLD at baseline. Logistic regression model was used to calculate the odd ratio (OR) of NAFLD. Results Compared with those without NAFLD, individuals with mild or moderate/severe NAFLD had a monotonic elevated risk of developing T2DM (HR: 1.88 [95% CI: 1.63–2.18] and 2.34 [1.85–2.96], respectively) after adjustment for potential confounders. In a parallel analysis, compared to participants with fasting plasma glucose < 6.1 mmol/L, the ORs of developing NAFLD in subjects with impaired fasting glucose and T2DM were 1.35 (95% CI: 1.16–1.57) and 1.40 (95% CI: 1.22–1.62), respectively. Conclusions Our results provide compelling evidence that the NAFLD-T2DM association is bidirectional in Chinese population.