Nishi Takumi, Babazono Akira, Maeda Toshiki, Imatoh Takuya, Une Hiroshi
Department of Health Care Administration and management, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Department of Hygiene and Preventive Medicine, Fukuoka University Fukuoka, Japan.
J Diabetes Investig. 2015 May;6(3):309-16. doi: 10.1111/jdi.12290. Epub 2014 Nov 10.
AIMS/INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in developed countries, and it was required to monitor patients with prediabetes. However, there have been few reports establishing the risk for diabetes mellitus (DM) among patients with prediabetes. The purpose of the present study was to evaluate the effect of NAFLD on the progression of DM among insurance beneficiaries with prediabetes, using data from specific health check-ups and the fatty liver index (FLI).
We used a retrospective cohort study that enrolled 967 insurance beneficiaries with prediabetes who had rarely drunk or could not drink alcohol, or whose alcohol consumption was <19 g/day from two health insurance societies. We divided insurance beneficiaries into FLI <30, intermediates FLIs and FLI ≥60, and compared the incidence rate of DM among the groups after 3 years' follow up, using multiple logistic regression models.
During 3 years' follow up, progression of diabetes was seen in 65 men (11.5%) and 24 women (6.0%). Logistic regression analyses showed that those with NAFLD had significantly higher risks of developing DM; this was the case in both men (odds ratio 2.68, 95% confidential interval 1.29-5.56) and women (odds ratio 10.35, 95% confidential interval 3.22-33.31).
Among insurance beneficiaries with prediabetes, those with NAFLD had a significantly higher risk of DM than those without NAFLD. The FLI might be useful for detecting individuals who have an especially higher risk for DM, and developing more effective guidance for delivering healthcare services in Japan.
目的/引言:非酒精性脂肪性肝病(NAFLD)是发达国家最常见的肝脏疾病,对糖尿病前期患者进行监测很有必要。然而,关于糖尿病前期患者发生糖尿病(DM)风险的报道较少。本研究旨在利用特定健康检查数据和脂肪肝指数(FLI),评估NAFLD对糖尿病前期保险受益人群中DM进展的影响。
我们采用回顾性队列研究,纳入了来自两个健康保险协会的967名很少饮酒或不饮酒、或酒精摄入量<19克/天的糖尿病前期保险受益人。我们将保险受益人分为FLI<30、FLI中等和FLI≥60三组,并使用多元逻辑回归模型比较3年随访后各组DM的发病率。
在3年的随访中,65名男性(11.5%)和24名女性(6.0%)出现了糖尿病进展。逻辑回归分析表明,患有NAFLD的人发生DM的风险显著更高;男性(优势比2.68,95%置信区间1.29-5.56)和女性(优势比10.35,95%置信区间3.22-33.31)均是如此。
在糖尿病前期保险受益人中,患有NAFLD的人发生DM的风险明显高于没有NAFLD的人。FLI可能有助于检测出DM风险特别高的个体,并为日本的医疗服务提供更有效的指导。