Ming Jie, Xu Shaoyong, Gao Bin, Liu Guocai, Ji Yufei, Yang Fan, Jia Yunan, Fang Yujie, Ji Qiuhe
Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Department of Infectious Diseases, 273 Hospital of PLA, Kuele, China.
Liver Int. 2015 Nov;35(11):2401-7. doi: 10.1111/liv.12851. Epub 2015 May 5.
BACKGROUND & AIMS: Emerging studies have focused the association between non-alcoholic fatty liver disease (NAFLD) and the risk of type 2 diabetes mellitus (T2DM) but the results were inconsistent. In addition, few studies have put focus on the association between NAFLD and the risk of prediabetes. We aimed to investigate whether NAFLD diagnosed by ultrasonography could predict the risk of future T2DM and prediabetes in Chinese population.
The population-based cohort study held in Xi'an, Northwestern China, was based on China National Diabetes and Metabolic Disorders Survey. During a follow-up of 5 years, 508 healthy subjects were included as study sample. NAFLD was determined by abdominal ultrasonography. T2DM and prediabetes were diagnosed based on oral glucose tolerance test.
Of 508 subjects, 97 (19.1%) were diagnosed as NAFLD and 411 (80.9%) were as non-NAFLD; 20 (3.9%) developed diabetes and 85 (16.7%) developed prediabetes during follow-up. The incidence of diabetes and prediabetes in the NAFLD group was 20.6 and 51.6 per 1000 person-years, respectively, whereas that in non-NAFLD group was 4.9 and 29.2 per 1000 person-years respectively. Cox proportional hazard regression showed that the multivariable-adjusted relative risk (RR) of T2DM and prediabetes in the NAFLD group was 4.462 [95% confidence interval (CI): 1.855-10.734, P < 0.001] and 1.642 (95% CI: 0.965-2.793, P = 0.067), respectively, compared with non-NAFLD group.
Non-alcoholic fatty liver disease was a significant predictor for future diabetes, but not for prediabetes, in Xi'an, China. More cohort studies are needed to confirm our findings.
新兴研究聚焦于非酒精性脂肪性肝病（NAFLD）与2型糖尿病（T2DM）风险之间的关联，但结果并不一致。此外，很少有研究关注NAFLD与糖尿病前期风险之间的关联。我们旨在调查超声诊断的NAFLD是否能预测中国人群未来患T2DM和糖尿病前期的风险。
基于中国国家糖尿病和代谢紊乱调查，在中国西北部西安进行了一项基于人群的队列研究。在5年的随访期间，纳入508名健康受试者作为研究样本。通过腹部超声确定NAFLD。根据口服葡萄糖耐量试验诊断T2DM和糖尿病前期。
508名受试者中，97名（19.1%）被诊断为NAFLD，411名（80.9%）为非NAFLD；随访期间，20名（3.9%）患糖尿病，85名（16.7%）患糖尿病前期。NAFLD组糖尿病和糖尿病前期的发病率分别为每1000人年20.6例和51.6例，而非NAFLD组分别为每1000人年4.9例和29.2例。Cox比例风险回归显示，与非NAFLD组相比，NAFLD组T2DM和糖尿病前期的多变量调整相对风险（RR）分别为4.462 [95%置信区间（CI）：1.855 - 10.734，P < 0.001]和1.642（95% CI：0.965 - 2.793，P = 0.067）。
在中国西安，非酒精性脂肪性肝病是未来糖尿病的重要预测指标，但不是糖尿病前期的预测指标。需要更多的队列研究来证实我们的发现。
