Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, Florida.
Virginia Commonwealth University Medical Center, Richmond, Virginia.
Diabetes Obes Metab. 2017 Nov;19(11):1630-1634. doi: 10.1111/dom.12973. Epub 2017 Jun 22.
We investigated non-alcoholic fatty liver disease (NAFLD) prevalence and its metabolic associations in patients with type 1 diabetes (T1D), and in insulin-naïve and insulin-treated patients with type 2 diabetes (T2D). Baseline data from patients who had liver fat content (LFC) evaluated by magnetic resonance imaging in four phase 3 studies of basal insulin peglispro (BIL) were analysed. Associations of NAFLD with clinical characteristics, glycaemic control and diabetes therapy were evaluated. The prevalence of NAFLD (defined as LFC ≥ 6%) was low in T1D (8.8%) but high in T2D, with greater prevalence in insulin-naïve (75.6%) vs insulin-treated (61.7%) T2D patients. LFC (mean ± SD) was higher in T2D patients (insulin-naïve, 13.0% ± 8.4%; insulin-treated, 10.2% ± 7.8%) than in T1D patients (3.2% ± 3.2%). In T2D, NAFLD was associated with several markers of insulin resistance. In all three populations, there was an absence of association of HbA1c with LFC, but insulin doses were higher in patients with NAFLD.
我们调查了 1 型糖尿病(T1D)患者、未经胰岛素治疗和经胰岛素治疗的 2 型糖尿病(T2D)患者中非酒精性脂肪性肝病(NAFLD)的患病率及其与代谢的关系。对四项基础胰岛素培格利司他(BIL)的 3 期研究中通过磁共振成像评估肝脂肪含量(LFC)的患者的基线数据进行了分析。评估了 NAFLD 与临床特征、血糖控制和糖尿病治疗的相关性。T1D 患者中 NAFLD(定义为 LFC≥6%)的患病率较低(8.8%),但 T2D 患者的患病率较高,未经胰岛素治疗(75.6%)的 T2D 患者高于经胰岛素治疗(61.7%)的 T2D 患者。T2D 患者的 LFC(平均值±标准差)高于 T1D 患者(未经胰岛素治疗,13.0%±8.4%;经胰岛素治疗,10.2%±7.8%)。在 T2D 中,NAFLD 与多种胰岛素抵抗标志物相关。在所有三个人群中,LFC 与 HbA1c 均无相关性,但 NAFLD 患者的胰岛素剂量更高。