Department of Internal Medicine, Diabetes Unit, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77-3º andar-Vila Isabel, Rio de Janeiro-RJ CEP 20551-030, Brazil.
Department of Ophthalmology, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77-4º andar-Vila Isabel, Rio de Janeiro-RJ CEP 20551-030, Brazil.
Nutrients. 2017 Aug 15;9(8):878. doi: 10.3390/nu9080878.
Obesity is increasing worldwide, affecting even patients with type 1 diabetes (T1D). A higher prevalence of associated comorbidities is expected, such as non-alcoholic fatty liver disease (NAFLD). This paper reports a cross-sectional multicenter study on a population with T1D ( = 1662), which aimed to evaluate the prevalence of metabolic syndrome (MS), a known risk factor for NAFLD, and to investigate predisposing factors associated with MS, as well as factors associated with elevated alanine aminotransferase (ALT), as it correlates to liver fat content. Patients were from 14 public clinics of 10 cities from all geographical regions of Brazil. A high prevalence of MS was found, especially among adults (32.3%), and this was related to age, female gender, acid uric levels, and the presence of acanthosis nigricans. ALT above the normal range was associated with triglyceride levels (especially above 129.5 mg/dL), serum uric acid, age, male gender, HbA1c, and non-Caucasian ethnicity. Patients with T1D, metabolic syndrome, and the aforementioned factors may be at a higher risk of NAFLD and should be referred to ultrasound for NAFLD evaluation. Further studies are necessary to establish the prevalence of NAFLD in individuals with T1D and to determine the disease's progression in these patients.
肥胖症在全球范围内不断增加，甚至影响到了 1 型糖尿病（T1D）患者。预计会有更多与肥胖相关的合并症，如非酒精性脂肪性肝病（NAFLD）。本文报告了一项针对 T1D 患者（n=1662）的横断面多中心研究，旨在评估代谢综合征（MS）的患病率，MS 是 NAFLD 的已知危险因素，并探讨与 MS 相关的易患因素，以及与丙氨酸氨基转移酶（ALT）升高相关的因素，因为它与肝脂肪含量相关。患者来自巴西 10 个城市的 14 个公共诊所，分布于巴西所有地理区域。研究发现 MS 的患病率很高，尤其是成年人（32.3%），且这与年龄、女性、尿酸水平和黑棘皮病的存在有关。ALT 超过正常范围与甘油三酯水平（尤其是超过 129.5mg/dL）、尿酸、年龄、男性、HbA1c 和非白种人种族有关。患有 T1D、代谢综合征和上述因素的患者可能面临更高的 NAFLD 风险，应转介进行超声检查以评估 NAFLD。有必要开展进一步的研究，以确定 T1D 患者中 NAFLD 的患病率，并确定该疾病在这些患者中的进展情况。
