Prevalence of non-alcoholic fatty liver disease in urban south Indians in relation to different grades of glucose intolerance and metabolic syndrome
Prevalence of non-alcoholic fatty liver disease in urban south Indians in relation to different grades of glucose intolerance and metabolic syndrome
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DOI：
10.1016/j.diabres.2008.11.039
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发表时间：
2009-04-01
影响因子：
5.1
通讯作者：
Pitchumoni, C. S.
中科院分区：
文献类型：
--
作者：
Mohan, V.;Farooq, S.;Pitchumoni, C. S.
目的：了解印度南部城市人群中非酒精性脂肪性肝病(NAFLD)的患病率及其与糖耐量异常(2型糖尿病、前驱糖尿病)和代谢综合征(MS)的关系。方法：在金奈城乡流行病学研究中，对26001名原始样本中的541名受试者(应答率92%)进行调查，以保持代表性。除了自我报告的糖尿病受试者外，所有受试者都进行了人体测量和血脂评估，并进行了口服葡萄糖耐量试验。NAFLD的诊断采用超声检查，MS采用改良的成人治疗小组III(ATPIII)标准。结果：非酒精性脂肪肝的总患病率为32%(男：35.1%，女：29.1%，P=0.140)。在NAFLD受试者中，大多数心脏代谢危险因素的患病率显著更高。糖尿病患者的非酒精性脂肪肝患病率(54.5%)高于糖尿病前期(33%)、单纯糖耐量低减(32.4%)、单纯糖耐量低减(27.3%)和正常糖耐量(22.5%)(DM与糖尿病前期：P<；0.05，DM与NGT：P<；0.001，糖尿病前期与NGT：P<；0.05)。即使在调整了年龄、性别和腰围后，NAFLD仍与糖尿病(OR：2.9，95%C.I.：1.9-4.6p<；0.001)和多发性硬化症(OR：2.0，95%C.I.：1.3-3.1，p<；0.001)相关。结论：NAFLD存在于三分之一的城市亚裔印度人中，其患病率随着糖耐量异常程度的增加而增加，在MS中，这是南亚地区首例以人群为基础的NAFLD患病率，面临糖尿病疫情的首当其冲。(C)2009年，爱思唯尔爱尔兰有限公司出版。
Aim: To estimate prevalence of non-alcoholic fatty liver disease (NAFLD) and its association with glucose intolerance (type 2 diabetes (DM), prediabetes) and metabolic syndrome (MS) in urban south Indians.Methods: This study was carried out in 541 subjects (response rate 92%) of the original sample of 26,001 subjects in the Chennai Urban Rural Epidemiology Study maintaining the representativeness. Anthropometry and lipid estimations were done in all and oral glucose tolerance test in all, except self-reported diabetic subjects. NAFLD was diagnosed by ultrasonography and MS by modified Adult Treatment Panel III (ATP III) criteria. DM, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were defined using WHO consulting group criteria.Results: Overall prevalence of NAFLD was 32% (173/541 subjects) (men: 35.1%, women: 29.1%, p = 0.140). Prevalence of most cardio-metabolic risk factors was significantly higher in NAFLD subjects. Prevalence of NAFLD (54.5%) was higher in subjects with DM compared to those with prediabetes (IGT or IFG) (33%), isolated IGT (32.4%), isolated IFG (27.3%) and normal glucose tolerance (NGT) (22.5%) (DM vs. prediabetes: p < 0.05, DM vs. NGT: p < 0.001, prediabetes vs. NGT: p < 0.05). Even after adjusting for age, gender and waist circumference, NAFLD was associated with diabetes (OR: 2.9,95% C.I.: 1.9-4.6, p < 0.001) and MS (OR: 2.0,95% C.I.: 1.3-3.1, p < 0.001).Conclusion: NAFLD is present in a third of urban Asian Indians and its prevalence increases with increasing severity of glucose intolerance and in MS. This is the first population-based prevalence of NAFLD from south Asia which faces the brunt of the diabetes epidemic. (C) 2009 Published by Elsevier Ireland Ltd.