性别特异性在糖尿病前期和 2 型糖尿病患者中非酒精性脂肪性肝病患病率的差异。

Sex-specific differences in prevalence of nonalcoholic fatty liver disease in subjects with prediabetes and type 2 diabetes.

机构信息

Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy.

Department of Systems Medicine, University of Rome-Tor Vergata, Italy.

出版信息

Diabetes Res Clin Pract. 2022 Aug;190:110027. doi: 10.1016/j.diabres.2022.110027. Epub 2022 Jul 30.

DOI:10.1016/j.diabres.2022.110027

PMID:35917992

Abstract

AIMS

To characterize the prevalence of NAFLD among subjects with NGT, prediabetes and type 2 diabetes (T2DM) by sex in adults with one or more cardio-metabolic risk factors, and to assess whether cardio-metabolic factors explained sex-related differences in NAFLD prevalence.

METHODS

The study sample encompasses 742 individuals with NGT, 553 with prediabetes, and 431 with T2DM.

RESULTS

Women with prediabetes and T2DM exhibited greater relative differences in waist circumference, HOMA-IR, hsCRP, and lipid profile than prediabetic and diabetic men when compared with their NGT counterparts. Formal tests for glucose tolerance status × sex interaction were statistically significant for waist circumference (P = 0.008), HOMA-IR (P = 0.03), total cholesterol (P = 0.003), LDL (P = 0.001), HDL (P = 0.006), triglycerides (P < 0.0001), and hsCRP (P < 0.05). In a logistic regression analysis, prediabetic and diabetic women exhibited a higher OR for NAFLD than their male counterparts with test for glucose tolerance status × sex interaction being statistically significant.

CONCLUSIONS

Prediabetic and diabetic women have higher OR of having NAFLD than men. Deterioration of glucose homeostasis in women is associated with a greater worsening in metabolic risk factors than men, which may explain the stronger impact of prediabetes and T2DM on NAFLD in women.

摘要

目的

在存在一种或多种心血管代谢危险因素的成年人中，按性别描述非酒精性脂肪性肝病（NAFLD）在正常糖耐量（NGT）、糖尿病前期和 2 型糖尿病（T2DM）患者中的流行率，并评估心血管代谢因素是否解释了 NAFLD 流行率的性别差异。

方法

研究样本包括 742 名 NGT 患者、553 名糖尿病前期患者和 431 名 T2DM 患者。

结果

与 NGT 对照相比，患有糖尿病前期和 T2DM 的女性在腰围、HOMA-IR、hsCRP 和血脂谱方面的相对差异大于糖尿病前期和糖尿病男性。葡萄糖耐量状态×性别交互作用的正式检验在腰围（P=0.008）、HOMA-IR（P=0.03）、总胆固醇（P=0.003）、LDL（P=0.001）、HDL（P=0.006）、甘油三酯（P<0.0001）和 hsCRP（P<0.05）方面具有统计学意义。在逻辑回归分析中，糖尿病前期和糖尿病女性发生 NAFLD 的 OR 高于其男性对照，葡萄糖耐量状态×性别交互作用的检验具有统计学意义。