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基于社区的中国人群中,非酒精性脂肪性肝病与不同葡萄糖耐量人群的发病率和共病率。

The Morbidity and Comorbidity of Nonalcoholic Fatty Liver Disease and Different Glucose Intolerance Strata in a Community-Based Chinese Population.

机构信息

Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Centre, Beijing, China.

Department of Endocrinology and Metabolism, Pinggu Hospital, Capital Medical University, Beijing, China.

出版信息

Metab Syndr Relat Disord. 2020 Aug;18(6):284-290. doi: 10.1089/met.2019.0107. Epub 2020 May 27.

Abstract

To investigate the morbidity and comorbidity of nonalcoholic fatty liver disease (NAFLD) and different glucose intolerance strata in a community-based population and to explore the association between glucose tolerance levels and NAFLD. A community-based cohort established for Pinggu Metabolic Disease Study in a suburb of Beijing, China, was established from September 2013 to July 2014 using a random sampling method. Participants were eligible if they were born in Pinggu and had been living there for at least 5 years within the age range of 26-76 years. A 75 grams oral glucose tolerance test was used to determine the strata of glucose tolerance. Unenhanced abdominal computed tomography scan was performed to identify NAFLD. A total of 3122 subjects were included in this analysis. The prevalence of NAFLD was 22.68% (27.58% vs. 19.97% among men and women). The prevalence of type 2 diabetes (T2D) was 18.03% (20.83% vs. 16.22% among men and women). Up to 7.21% of residents had both T2D and NAFLD. 39.96% of diabetic patients and 28.77% of prediabetic patients combined with NAFLD. Compared with adults with normal glucose tolerance, the incidence of NAFLD in T2D patients was more than three times higher after adjusting for sex, age, body mass index (BMI), sedentary time, and dietary habit [odds ratio (OR) = 3.58, confidence interval (95% CI) 2.80-4.58,  < 0.001]. NAFLD was also more common in individuals with prediabetes, especially patients with impaired glucose tolerance (IGT) (OR = 2.27, 1.75-2.95) or impaired fasting glucose+IGT (OR = 2.78, 1.92-4.03). The morbidity and comorbidity of NAFLD and glucose intolerance are high in the Pinggu population in northern China, highlighting the importance of early prevention and treatment of these two diseases at the same time.

摘要

目的

在中国北方的平谷人群中,调查非酒精性脂肪性肝病(NAFLD)和不同葡萄糖耐量人群的发病率和共病率,并探讨葡萄糖耐量水平与 NAFLD 之间的关系。

方法

本研究采用随机抽样的方法,从 2013 年 9 月至 2014 年 7 月,建立了一个北京郊区的平谷代谢性疾病研究社区为基础的队列。参与者必须满足以下条件:出生于平谷,且在年龄 26-76 岁之间在当地居住至少 5 年。采用 75 克口服葡萄糖耐量试验来确定葡萄糖耐量水平。进行未增强的腹部计算机断层扫描以确定 NAFLD。

结果

共有 3122 名参与者被纳入本分析。NAFLD 的患病率为 22.68%(男性和女性分别为 27.58%和 19.97%)。2 型糖尿病(T2D)的患病率为 18.03%(男性和女性分别为 20.83%和 16.22%)。高达 7.21%的居民同时患有 T2D 和 NAFLD。39.96%的糖尿病患者和 28.77%的糖尿病前期患者合并有 NAFLD。与正常葡萄糖耐量的成年人相比,调整性别、年龄、体重指数(BMI)、久坐时间和饮食习惯后,T2D 患者发生 NAFLD 的风险增加了三倍以上[比值比(OR)=3.58,95%置信区间(95%CI)2.80-4.58,<0.001]。NAFLD 在糖尿病前期患者中也更为常见,尤其是葡萄糖耐量受损(IGT)(OR=2.27,1.75-2.95)或空腹血糖受损+IGT(OR=2.78,1.92-4.03)患者。

结论

在中国北方的平谷人群中,NAFLD 和葡萄糖耐量异常的发病率和共病率较高,这凸显了同时预防和治疗这两种疾病的重要性。

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