Sobhonslidsuk Abhasnee, Pulsombat Akharawit, Kaewdoung Piyaporn, Petraksa Supanna
Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand E-mail :
Asian Pac J Cancer Prev. 2015;16(5):1789-94. doi: 10.7314/apjcp.2015.16.5.1789.
Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment.
To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors.
One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ≥7 kPa was used to define significant hepatic fibrosis.
Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis.
Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.
非酒精性脂肪性肝病（NAFLD）是糖尿病中最常见的肝脏问题，是肝癌的危险因素。糖尿病、高体重指数（BMI）和高龄均会促使NAFLD病情进展。瞬时弹性成像（TE）用于无创性纤维化评估。
确定糖尿病患者中NAFLD和显著肝纤维化的患病率，并评估相关因素。
对141例糖尿病患者和60例正常受试者进行筛查。当超声检查发现肝脏回声增强和血管变钝时诊断为脂肪肝。通过TE评估代表肝纤维化的肝脏硬度测量值（LSM）。LSM≥7 kPa用于定义显著肝纤维化。
4例因乙肝病毒标志物阳性和TE失败而被排除。糖尿病患者的BMI、收缩压、腰围和空腹血糖水平高于正常受试者。82例（60.7%）糖尿病患者被诊断为脂肪肝，而正常组无一例诊断为脂肪肝。BMI（比值比：1.31；95%置信区间：1.02 - 1.69；p = 0.038）和丙氨酸氨基转移酶（ALT）（比值比：1.14；95%置信区间：1.05 - 1.23；p = 0.002）与NAFLD相关。患有NAFLD的糖尿病患者的LSM高于未患NAFLD的患者[5.99（2.4）对4.76（2.7）kPa，p = 0.005]。显著肝纤维化在糖尿病患者中比在正常受试者中更常见[22例（16.1%）对1例（1.7%），p = 0.002]。天冬氨酸氨基转移酶（AST）（比值比：1.24；95%置信区间：1.07 - 1.42；p = 0.003）与显著肝纤维化相关。
发现60%的糖尿病患者患有NAFLD，16%的糖尿病患者患有显著肝纤维化。高BMI和ALT水平是NAFLD的预测因素，而AST水平升高与显著肝纤维化相关。
Zotero 插件