Diabetes Care. 2018 Feb;41(2):341-347. doi: 10.2337/dc17-1590. Epub 2017 Nov 22.
To describe associations between alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with type 2 diabetes mellitus (T2DM).
We performed a retrospective cohort study by using linked population-based routine data from diabetes registry, hospital, cancer, and death records for people aged 40-89 years diagnosed with T2DM in Scotland between 2004 and 2013 who had one or more hospital admission records. Liver disease and outcomes were identified by using ICD-9 and ICD-10 codes. We estimated hazard ratios (HRs) from Cox proportional hazards regression models, adjusting for key risk factors.
A total of 134,368 people with T2DM (1,707 with ALD and 1,452 with NAFLD) were studied, with a mean follow-up of 4.3 years for CVD and 4.7 years for mortality. Among those with ALD, NAFLD, or without liver disease hospital records 378, 320, and 21,873 CVD events; 268, 176, and 15,101 cancers; and 724, 221, and 16,203 deaths were reported, respectively. For ALD and NAFLD, respectively, adjusted HRs (95% CIs) compared with the group with no record of liver disease were 1.59 (1.43, 1.76) and 1.70 (1.52, 1.90) for CVD, 40.3 (28.8, 56.5) and 19.12 (11.71, 31.2) for hepatocellular carcinoma (HCC), 1.28 (1.12, 1.47) and 1.10 (0.94, 1.29) for non-HCC cancer, and 4.86 (4.50, 5.24) and 1.60 (1.40, 1.83) for all-cause mortality.
Hospital records of ALD or NAFLD are associated to varying degrees with an increased risk of CVD, cancer, and mortality among people with T2DM.
描述 2 型糖尿病患者（T2DM）的酒精性肝病（ALD）或非酒精性脂肪性肝病（NAFLD）住院与心血管疾病（CVD）、癌症和死亡之间的关联。
我们进行了一项回顾性队列研究，使用苏格兰 2004 年至 2013 年间确诊为 T2DM 的 40-89 岁人群的糖尿病登记处、医院、癌症和死亡记录的基于人群的常规数据进行研究。通过 ICD-9 和 ICD-10 代码识别肝脏疾病和结局。我们使用 Cox 比例风险回归模型估计风险比（HRs），并进行了关键风险因素的调整。
共纳入 134368 名 T2DM 患者（ALD 患者 1707 例，NAFLD 患者 1452 例），CVD 的中位随访时间为 4.3 年，死亡率的中位随访时间为 4.7 年。在有 ALD、NAFLD 或无肝脏疾病住院记录的患者中，分别报告了 378、320 和 21873 例 CVD 事件；268、176 和 15101 例癌症；724、221 和 16203 例死亡。ALD 和 NAFLD 患者的调整后 HR（95%CI）与无肝脏疾病记录的患者相比，分别为 1.59（1.43，1.76）和 1.70（1.52，1.90），CVD 风险；40.3（28.8，56.5）和 19.12（11.71，31.2），肝细胞癌（HCC）风险；1.28（1.12，1.47）和 1.10（0.94，1.29），非 HCC 癌症风险；4.86（4.50，5.24）和 1.60（1.40，1.83），全因死亡率。
T2DM 患者的 ALD 或 NAFLD 住院记录与 CVD、癌症和死亡风险的增加程度不同。
