Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt.
Int J Environ Res Public Health. 2018 Nov 11;15(11):2521. doi: 10.3390/ijerph15112521.
The objective of this study was to determine the prevalence and the factors associated with non-alcoholic fatty liver disease (NAFLD) among type-2 diabetes mellitus (T2DM) patients in Abha City, Southwestern Saudi Arabia. Using a cross-sectional study design, a representative sample of 245 T2DM patients were recruited from all primary healthcare centers in Abha city. A detailed medical history as well as laboratory investigations were done. NAFLD was diagnosed using abdominal ultrasound examination. The overall prevalence of NAFLD was 72.8% (95% CI: 66.6%⁻78.1%). In a multivariable regression analysis, the risk of NAFLD was significantly higher among overweight T2DM patients (aOR = 6.112, 95% CI: 1.529⁻4.432), Obese (aOR = 10.455, 95% CI: 2.645⁻41.326), with high ALT of more than 12 IU/L (aOR = 2.335, 95% CI: 1.096⁻5.062), moderate diet-compliant patients (aOR = 2.413, 95% CI: 1.003⁻5.805) and poor diet-compliant patients (aOR = 6.562, 95% CI: 2.056⁻20.967). On the other hand, high HDL (high density cholesterol) (in mg/dL) was a protective factor for NAFLD (aOR = 0.044, 95% CI: 0.005⁻0.365). It was concluded that NAFLD is a common association of T2DM. Increasing BMI (Body mass index), lower HDL level, and poor dietary control are significant factors associated with NAFLD among T2DM patients. Health education to improve dietary control and avoid excessive weight gain, testing for NAFLD among diabetic patients, especially those with abnormal BMI and HDL, are recommended for early detection and to ensure optimal levels of HDL.
本研究旨在确定沙特阿拉伯西南部阿巴市 2 型糖尿病（T2DM）患者中非酒精性脂肪性肝病（NAFLD）的患病率及其相关因素。采用横断面研究设计，从阿巴市所有初级保健中心招募了 245 名 T2DM 患者的代表性样本。进行了详细的病史和实验室检查。使用腹部超声检查诊断 NAFLD。NAFLD 的总体患病率为 72.8%（95%CI：66.6%-78.1%）。在多变量回归分析中，超重 T2DM 患者（aOR=6.112，95%CI：1.529-4.432）、肥胖（aOR=10.455，95%CI：2.645-41.326）、丙氨酸转氨酶（ALT）高于 12IU/L 的患者（aOR=2.335，95%CI：1.096-5.062）、中度饮食依从性患者（aOR=2.413，95%CI：1.003-5.805）和饮食依从性差的患者（aOR=6.562，95%CI：2.056-20.967）发生 NAFLD 的风险显著更高。另一方面，较高的高密度脂蛋白（HDL）（mg/dL）是 NAFLD 的保护因素（aOR=0.044，95%CI：0.005-0.365）。研究结论为，NAFLD 是 T2DM 的常见合并症。BMI（体重指数）增加、HDL 水平降低和饮食控制不良是 T2DM 患者中与 NAFLD 相关的重要因素。建议对糖尿病患者，尤其是 BMI 和 HDL 异常的患者，进行 NAFLD 检测，开展健康教育以改善饮食控制和避免体重过度增加，从而实现 NAFLD 的早期发现并确保 HDL 水平处于最佳状态。
