Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Centre for Liver Disease Research, Translational Research Institute, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Can J Gastroenterol Hepatol. 2017;2017:7927685. doi: 10.1155/2017/7927685. Epub 2017 Nov 1.
To examine the association between lifetime alcohol consumption and significant liver disease in type 2 diabetic patients with NAFLD.
A cross-sectional study assessing 151 patients with NAFLD at risk of clinically significant liver disease. NAFLD fibrosis severity was classified by transient elastography; liver stiffness measurements ≥8.2 kPa defined significant fibrosis. Lifetime drinking history classified patients into nondrinkers, light drinkers (always ≤20 g/day), and moderate drinkers (any period with intake >20 g/day).
Compared with lifetime nondrinkers, light and moderate drinkers were more likely to be male ( = 0.008) and to be Caucasian ( = 0.007) and to have a history of cigarette smoking ( = 0.000), obstructive sleep apnea ( = 0.003), and self-reported depression ( = 0.003). Moderate drinkers required ≥3 hypoglycemic agents to maintain diabetic control ( = 0.041) and fibrate medication to lower blood triglyceride levels ( = 0.044). Compared to lifetime nondrinkers, light drinkers had 1.79 (95% CI: 0.67-4.82; = 0.247) and moderate drinkers had 0.91 (95% CI: 0.27-3.10; = 0.881) times the odds of having liver stiffness measurements ≥8.2 kPa (adjusted for age, gender, and body mass index).
In diabetic patients with NAFLD, light or moderate lifetime alcohol consumption was not significantly associated with liver fibrosis. The impact of lifetime alcohol intake on fibrosis progression and diabetic comorbidities, in particular obstructive sleep apnea and hypertriglyceridemia, requires further investigation.
探讨 2 型糖尿病合并非酒精性脂肪性肝病(NAFLD)患者终生饮酒与显著肝脏疾病的关系。
这是一项横断面研究,共评估了 151 例有发生临床显著肝脏疾病风险的 NAFLD 患者。通过瞬时弹性成像评估 NAFLD 纤维化严重程度;肝脏硬度测量值≥8.2kPa 定义为显著纤维化。终生饮酒史将患者分为不饮酒者、轻度饮酒者(始终≤20g/天)和中度饮酒者(任何时期的摄入量>20g/天)。
与终生不饮酒者相比,轻度和中度饮酒者更有可能是男性( = 0.008)和白种人( = 0.007),且有吸烟史( = 0.000)、阻塞性睡眠呼吸暂停( = 0.003)和自述抑郁史( = 0.003)。中度饮酒者需要≥3 种降糖药物来控制糖尿病( = 0.041)和使用贝特类药物来降低血三酰甘油水平( = 0.044)。与终生不饮酒者相比,轻度饮酒者发生肝脏硬度测量值≥8.2kPa 的比值比为 1.79(95%可信区间:0.67-4.82; = 0.247),中度饮酒者为 0.91(95%可信区间:0.27-3.10; = 0.881)(校正年龄、性别和体重指数后)。
在患有 NAFLD 的糖尿病患者中,轻度或中度终生饮酒与肝纤维化无显著相关性。终生饮酒对纤维化进展和糖尿病合并症(特别是阻塞性睡眠呼吸暂停和高三酰甘油血症)的影响需要进一步研究。