Ma Y B, Cheng N, Lu Y B, Li H Y, Li J S, Ding J, Zheng S, Niu Y L, Pu H Q, Shen X P, Mu H D, Hu X B, Zhang D S, Bai Y N
Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China.
Institute of Epidemiology and Statistics,Basic Medical College, Lanzhou University, Lanzhou 730000, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Jun 10;39(6):760-764. doi: 10.3760/cma.j.issn.0254-6450.2018.06.013.
To explore the association between fatty liver and type 2 diabetes mellitus (T2DM) in the baseline-population of Jinchang cohort study. Data from all the participants involved in the baseline-population of Jinchang cohort study was used, to compare the risks of T2DM in fatty liver and non fatty liver groups and to explore the interaction between family history or fatty liver of diabetes and the prevalence of T2DM. Among all the 46 861 participants, 10 574 were diagnosed as having fatty liver (22.56), with the standardized rate as 20.66. Another 3 818 participants were diagnosed as having T2DM (8.15) with standardized rate as 6.90. The prevalence of T2DM increased in parallel with the increase of age (trend (2)=2 833.671, trend <0.001). The prevalence of T2DM in the fatty liver group was significantly higher than that in the non-fatty liver group, both in men or women and in the overall population. Compared with the group of non-fatty liver, the risks of T2DM in fatty liver group were seen 1.78 times higher in males, 2.33 times in women and 2.10 times in the overall population, after adjustment for factors as age, levels of education, smoking, drinking, physical exercise, BMI, family history of diabetes and some metabolic indicators (pressure, TC, TG, uric acid, ALT, AST, gamma-glutamyl transferase). Date from the interaction model showed that fatty liver and family history of diabetes present a positive additive interaction on T2DM (=1.18, 95: 0.59-1.78; =0.24, 95: 0.14-0.34; =1.43, 95: 1.21-1.69). Fatty liver could significantly increase the risk of T2DM and a positive additive interaction was also observed between fatty liver and family history of diabetes on T2DM. It was important to strengthen the prevention program on T2DM, in order to effectively control the development of fatty liver.
在金昌队列研究的基线人群中探讨脂肪肝与2型糖尿病(T2DM)之间的关联。使用了金昌队列研究基线人群中所有参与者的数据,比较脂肪肝组和非脂肪肝组患T2DM的风险,并探讨糖尿病家族史或脂肪肝与T2DM患病率之间的相互作用。在所有46861名参与者中,10574人被诊断为患有脂肪肝(22.56%),标准化率为20.66%。另有3818名参与者被诊断为患有T2DM(8.15%),标准化率为6.90%。T2DM的患病率随年龄增长而平行上升(趋势检验χ²=2833.671,趋势P<0.001)。无论男性、女性还是总体人群,脂肪肝组中T2DM的患病率均显著高于非脂肪肝组。在调整年龄、教育程度、吸烟、饮酒、体育锻炼、BMI、糖尿病家族史和一些代谢指标(血压、总胆固醇、甘油三酯、尿酸、谷丙转氨酶、谷草转氨酶、γ-谷氨酰转移酶)等因素后,与非脂肪肝组相比,脂肪肝组男性患T2DM的风险高1.78倍,女性高2.33倍,总体人群高2.10倍。交互作用模型的数据显示,脂肪肝与糖尿病家族史在T2DM上呈现正相加交互作用(归因比=1.18,95%置信区间:0.59 - 1.78;交互作用P=0.24,95%置信区间:0.14 - 0.34;交互作用归因比=1.43,95%置信区间:1.21 -