Okazaki City Medical Association, Public Health Center, Okazaki, Japan.
J Gastroenterol Hepatol. 2010 Feb;25(2):352-6. doi: 10.1111/j.1440-1746.2009.05998.x. Epub 2009 Oct 9.
The question of whether fatty liver might predict impaired fasting glucose or type 2 diabetes mellitus in a longitudinal manner was assessed in Japanese subjects undergoing a health checkup.
A total of 12 375 individuals (6799 men and 5576 women) without hyperglycemia or type 2 diabetes mellitus in 2000 and participating in 2005 were included. Multiple logistic regression analyses were performed for both sexes, adjusted for age, body mass index, elevated blood pressure or hypertension, family history of diabetes mellitus, alcohol drinking and smoking.
Impaired fasting glucose and type 2 diabetes mellitus were newly diagnosed in 7.6% and 1.0% of men and 3.8% and 0.5% of women, respectively, within the 5-year period. The prevalence of newly diagnosed impaired fasting glucose and type 2 diabetes mellitus was significantly higher in the participants with fatty liver than without fatty liver in both sexes. Fatty liver adjusted for the other factors was thus a risk factor for impaired fasting glucose and/or type 2 diabetes mellitus in both sexes (men odds ratio [OR] 1.91, 95% confidence interval [CI] 1.56-2.34 and women OR 2.15, 95% CI 1.53-3.01). The impact of fatty liver was stronger among the participants with a lower body mass index (men OR 0.92, 95% CI 0.86-0.99 and women OR 0.90, 95% CI 0.81-0.99, for one increment of body mass index).
Fatty liver is an independent risk factor for impaired fasting glucose and type 2 diabetes mellitus, having a stronger impact in those Japanese with a lower body mass index undergoing a health checkup.
本研究旨在评估日本体检人群中脂肪肝是否能前瞻性地预测空腹血糖受损或 2 型糖尿病。
共纳入 12375 名 2000 年无高血糖或 2 型糖尿病且参加 2005 年体检的个体(男 6799 名,女 5576 名)。对所有个体进行多因素 logistic 回归分析,校正年龄、体重指数、血压升高或高血压、糖尿病家族史、饮酒和吸烟。
在 5 年期间,男性中分别有 7.6%和 1.0%、女性中分别有 3.8%和 0.5%新诊断为空腹血糖受损和 2 型糖尿病。在男性和女性中,脂肪肝组新诊断空腹血糖受损和 2 型糖尿病的发生率均显著高于非脂肪肝组。因此,调整其他因素后,脂肪肝是男性(比值比 [OR] 1.91,95%置信区间 [CI] 1.56-2.34)和女性(OR 2.15,95%CI 1.53-3.01)空腹血糖受损和/或 2 型糖尿病的危险因素。在体重指数较低的参与者中,脂肪肝的影响更大(男性 OR 0.92,95%CI 0.86-0.99 和女性 OR 0.90,95%CI 0.81-0.99,每增加一个体重指数单位)。
脂肪肝是空腹血糖受损和 2 型糖尿病的独立危险因素,在日本体检人群中体重指数较低的个体中影响更大。