Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Department of Public Health, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan.
J Gastroenterol. 2017 Feb;52(2):237-244. doi: 10.1007/s00535-016-1234-9. Epub 2016 Jun 24.
It remains unclear whether fatty liver is a risk factor for the onset of abnormal glucose tolerance in any patient. The objective of this study was to clarify the relationship between fatty liver and the onset of impaired fasting glucose according to baseline fasting plasma glucose (FPG) levels.
This community-based longitudinal cohort study included 7,905 adults (3,863 men, 4,042 women; age range, 18-80 years) who had at least two annual checkups between 2003 and 2013. Those with FPG levels ≥110 mg/dl, taking anti-diabetic agents, and/or testing positive for hepatitis B surface antigen or anti-hepatitis C virus antibody were excluded, leaving 7,203 participants eligible for inclusion. All participants were divided into quartiles derived from their FPG levels at baseline. FPG ≥110 mg/dl during the observation period was defined as onset of IFG.
Onset of IFG was found in 7.7 % of men and 2.1 % of women (p < 0.001). After adjusting for age, body mass index, systolic blood pressure, triacylglycerol, high-density lipoprotein cholesterol, uric acid, creatinine, family history of diabetes, alcohol consumption, and current smoking, a positive association was found between fatty liver and the onset of IFG in both sexes with the highest quartile of FPG levels [men: adjusted hazard ratio (aHR) 1.823, 95 % confidence interval (CI) 1.316-2.534, p < 0.001; women: aHR 2.016, 95 % CI 1.117-3.6, p = 0.02].
Our results suggest that fatty liver is independently associated with an increased risk of developing IFG in individuals with high FPG.
目前尚不清楚脂肪肝是否是任何患者发生糖耐量异常的危险因素。本研究旨在根据空腹血糖（FPG）基线水平，明确脂肪肝与空腹血糖受损（IFG）发病之间的关系。
本社区纵向队列研究纳入了 7905 名成年人（3863 名男性，4042 名女性；年龄 18-80 岁），他们在 2003 年至 2013 年间至少接受了两次年度体检。排除 FPG 水平≥110mg/dl、服用降糖药以及/或乙型肝炎表面抗原或丙型肝炎病毒抗体阳性者，最终 7203 名参与者符合纳入标准。所有参与者均按基线 FPG 水平分为四分位数。观察期间 FPG≥110mg/dl 定义为 IFG 发病。
男性 IFG 发病率为 7.7%，女性为 2.1%（p<0.001）。调整年龄、体重指数、收缩压、三酰甘油、高密度脂蛋白胆固醇、尿酸、肌酐、糖尿病家族史、饮酒和当前吸烟状况后，在 FPG 水平最高四分位数的男性和女性中，脂肪肝与 IFG 发病之间存在正相关关系[男性：调整后危险比（aHR）1.823，95%置信区间（CI）1.316-2.534，p<0.001；女性：aHR 2.016，95%CI 1.117-3.6，p=0.02]。
我们的结果表明，在 FPG 较高的个体中，脂肪肝与 IFG 发病风险增加独立相关。
