Hazim Ahmad, Purnamasari Dyah, Kalista Kemal F, Lesmana C Rinaldi A, Nugroho Pringgodigdo
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Indonesia.
Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Indonesia.
Diabetes Metab Syndr. 2019 Mar-Apr;13(2):1431-1435. doi: 10.1016/j.dsx.2019.01.058. Epub 2019 Jan 31.
First degree relatives (FDR) of type 2 diabetes mellitus (T2DM) predisposes individuals to have earlier metabolic and vascular disorders independent of insulin resistance (IR) such as thicker carotid intima media thickness than that of non-FDR. Non-alcoholic fatty liver disease (NAFLD) is the most commonly found chronic liver disease in T2DM which is IR dependent. Studies about NAFLD in FDR of T2DM populations are very limited and inconclusive. It is unclear whether the occurrence of NAFLD in FDR of T2DM is IR dependent or due to genetic vulnerability.
The aim of this study is to determine the association between NAFLD and FDR of T2DM.
A total of 118 young adults (19-39 years old) with normal glucose tolerance (59 FDR of T2DM and age-sex matched 59 non-FDR subjects) were included in this cross-sectional study. Anthropometric measurement and routine laboratory analysis (fasting blood glucose/FBG, HbA1c, lipid profile, alanine aminotransferase (ALT), aspartate transaminase (AST)) were examined. Fatty liver was diagnosed by ultrasonography (US) using standard criteria.
Twenty-six (22,03%) subjects with NAFLD were detected by ultrasound with similar proportion for each group. Low HDL-C level and metabolic syndrome were found higher in FDR group (p = 0.004, OR 3.81, CI95 = 1.47-9,91; p = 0.023, OR 4.28, CI95 = 1.13-16.23). Based on logistic regression analysis, central obesity and obesity had statistically significant influence towards NAFLD.
The occurrence of NAFLD in FDR of T2DM was influenced by IR (central obesity and obesity).
2型糖尿病（T2DM）患者的一级亲属（FDR）易患早期代谢和血管疾病，且独立于胰岛素抵抗（IR），例如其颈动脉内膜中层厚度比非FDR人群更厚。非酒精性脂肪性肝病（NAFLD）是T2DM中最常见的慢性肝病，且与IR相关。关于T2DM人群FDR中NAFLD的研究非常有限且尚无定论。目前尚不清楚T2DM患者FDR中NAFLD的发生是与IR相关还是由于遗传易感性。
本研究旨在确定NAFLD与T2DM患者FDR之间的关联。
本横断面研究共纳入118名糖耐量正常的年轻成年人（19 - 39岁）（59名T2DM患者的FDR以及年龄和性别匹配的59名非FDR受试者）。进行人体测量和常规实验室分析（空腹血糖/FBG、糖化血红蛋白、血脂谱、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST））。采用标准标准通过超声（US）诊断脂肪肝。
超声检查发现26名（22.03%）受试者患有NAFLD，两组比例相似。FDR组的低高密度脂蛋白胆固醇（HDL - C）水平和代谢综合征发生率更高（p = 0.004，比值比（OR）3.81，95%置信区间（CI95）= 1.47 - 9.91；p = 0.023，OR 4.28，CI95 = 1.13 - 16.23）。基于逻辑回归分析，中心性肥胖和肥胖对NAFLD有统计学显著影响。
T2DM患者FDR中NAFLD的发生受IR（中心性肥胖和肥胖）影响。
