Prevalence and associated factors of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus
Prevalence and associated factors of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus
复制标题
DOI：
10.1111/j.1478-3231.2008.01718.x
复制
发表时间：
2009-01-01
影响因子：
6.7
通讯作者：
Cardoso, Claudia R. L.
中科院分区：
文献类型：
--
作者：
Leite, Nathalie C.;Salles, Gil F.;Cardoso, Claudia R. L.
糖尿病患者非酒精性脂肪肝（NAFLD）的患病率和严重程度增加。我们的目的是调查2型糖尿病患者超声NAFLD的患病率和相关因素，在一项横断面设计研究中，180例2型糖尿病患者接受了完整的临床和实验室评估以及腹部超声检查，以检测NAFLD并进行分级。统计学分析包括双变量检验、方差分析（anova，用于脂肪变性严重程度的增加）和多变量logistic回归。超声检查NAFLD的患病率为69.4% [95%可信区间（CI）：58.3-82.7%]。NAFLD患者比非脂肪变性患者更肥胖，腰围更大，血清甘油三酯和丙氨酸转氨酶（ALT）水平更高。无论是糖尿病退行性并发症，也不是血糖控制与肝脂肪变性。在多变量分析中，高血清甘油三酯水平[> 2.82 mmol/L，比值比（OR）：3.7-4.1，95% CI：1.2-13.3]和高正常ALT水平（>= 40 U/L，OR：2.5-2.7，95% CI：1.2-5.9）与肝脂肪变性独立相关，同时伴有肥胖2型糖尿病患者具有高的超声NAFLD患病率，并且其存在与肥胖（主要是腹部、高胆固醇血症和高正常ALT水平）相关。糖尿病患者的非酒精性脂肪肝可能独立于糖尿病本身的进展而发展和进展。
Diabetic patients have an increased prevalence and severity of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence and the factors associated with the presence of ultrasonographic NAFLD in type-2 diabetic individuals.In a cross-sectional design study, 180 type-2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. Statistical analysis included bivariate tests, analysis of variance (anova, for increasing severity of steatosis) and multivariate logistic regression.The prevalence of ultrasonographic NAFLD was 69.4% [95% confidence interval (CI): 58.3-82.7%]. Patients with NAFLD were more obese, had a higher waist circumference and serum triglyceride and alanine aminotransferase (ALT) levels than those without steatosis. Neither diabetic degenerative complication, nor glycaemic control was associated with liver steatosis. On multivariate analysis, a high serum triglycerides level [> 2.82 mmol/L, odds ratio (OR): 3.7-4.1, 95% CI: 1.2-13.3] and a high-normal ALT level (>= 40 U/L, OR: 2.5-2.7, 95% CI: 1.2-5.9) were independently associated with hepatic steatosis, together with either the presence of obesity (OR: 7.1, 95% CI: 3.0-17.0) or of increased waist circumference (OR: 4.8, 95% CI: 1.9-12.2).Type-2 diabetic patients have a high prevalence of ultrasonographic NAFLD and its presence is associated with obesity, mainly abdominal, hypertriglyceridaemia and high-normal ALT levels. Non-alcoholic fatty liver disease in diabetic patients may develop and progress independent of the diabetes progression itself.