Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Kyoto, Japan
BMJ Open Diabetes Res Care. 2020 Sep;8(1). doi: 10.1136/bmjdrc-2020-001629.
Both fatty liver disease (FLD) and alcohol consumption have been reported to affect incident type 2 diabetes mellitus. The aim of this study was to evaluate the combined effect of FLD and alcohol consumption on incident type 2 diabetes.
In this historical cohort study involving 9948 men, we investigated the influence of the presence of FLD and the grades of alcohol consumption on incident type 2 diabetes using Cox proportional hazards models. We categorized the participants into the following four groups: none or minimal alcohol consumption, <40 g/week; light, 40-140 g/week; moderate, 140-280 g/week; or heavy alcohol consumption, >280 g/week. FLD was diagnosed by abdominal ultrasonography.
During the median 6.0-year follow-up, 568 participants developed type 2 diabetes. Heavy alcohol consumers with FLD showed a higher risk for developing type 2 diabetes compared with the other groups. Moderate alcohol consumers without FLD had a significantly higher risk for developing incident type 2 diabetes, compared with none or minimal and light alcohol consumers without FLD. In contrast, there was no apparent difference in the risk for incident type 2 diabetes between none or minimal, light, and moderate alcohol consumers with FLD. Furthermore, there was no statistically significant difference in the risk for incident type 2 diabetes between a moderate and heavy alcohol consumer without FLD and a none or minimal, light, and moderate alcohol consumer with FLD.
To prevent incident type 2 diabetes, we should acknowledge that the impact of alcohol consumption may vary in the presence of FLD.
脂肪肝疾病（FLD）和饮酒都与 2 型糖尿病的发生有关。本研究旨在评估 FLD 和饮酒对 2 型糖尿病发生的综合影响。
本历史队列研究纳入了 9948 名男性，我们使用 Cox 比例风险模型，调查了 FLD 存在和饮酒程度对 2 型糖尿病发生的影响。我们将参与者分为以下四组：不饮酒或极少量饮酒（<40g/周）；少量饮酒（40-140g/周）；中度饮酒（140-280g/周）；或大量饮酒（>280g/周）。FLD 通过腹部超声诊断。
在中位数为 6.0 年的随访期间，568 名参与者发生了 2 型糖尿病。与其他组相比，患有 FLD 且大量饮酒的人群发生 2 型糖尿病的风险更高。与不饮酒或极少量饮酒且无 FLD 的人群相比，不饮酒或极少量、少量和中度饮酒且无 FLD 的人群发生 2 型糖尿病的风险显著更高。相反，在有 FLD 的情况下，不饮酒或极少量、少量和中度饮酒人群发生 2 型糖尿病的风险无明显差异。此外，在无 FLD 的情况下，中度和大量饮酒者与不饮酒或极少量、少量和中度饮酒且有 FLD 的人群发生 2 型糖尿病的风险无统计学差异。
为预防 2 型糖尿病，我们应该认识到在存在 FLD 的情况下，饮酒的影响可能会有所不同。
