Yang H, Chen S H, Yang L Y, Ma L G, Cao L Y, Wu S L
Oncology Department of Kailuan General Hospital, Tangshan 063000, China.
Internal Medicine-Cardiovascular Department of Kailuan General Hospital, Tangshan 063000, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 Jun 20;30(6):631-636. doi: 10.3760/cma.j.cn501113-20200804-00434.
To investigate the effect of nonalcoholic fatty liver (NAFLD) at different ages of onset with new-onset diabetes mellitus. The cohort study was conducted in Kailuan Group Company. Active and retired employees were used as study subjects. After excluding NAFLD diagnosed at baseline, previous history of diabetes mellitus, and long-term history of heavy drinking, 43 317 cases were finally included in the cohort. The study subjects were divided into five groups according to age (<30 years old as group 1, 30-39 years old as group 2, 40-49 years as group 3, 50-59 years as group 4, and ≥60 years as group 5). The prevalence and incidence density of new-onset diabetes mellitus were compared between each NAFLD and non-fatty liver population group. The effect of NAFLD at different ages of onset with new-onset diabetes mellitus was analyzed by multivariate Cox's regression model. Statistical analysis was performed using one-way ANOVA, test or multivariate Cox's regression model. The prevalence and incidence density of diabetes mellitus was significantly higher in NAFLD than non-fatty liver population. The prevalence of diabetes mellitus in different age groups were 6.45%, 6.88%, 9.94%, 10.83%, and 11.43%, respectively. The incidence density of each age group was 9.21/1 000 person-years, 11.10/1 000 person-years, 16.17/1 000 person-years, 18.72/1 000 person-years, and 22.13/1 000 person-years, and the differences were statistically significant (<0.001). Multivariate Cox's regression model result showed that after adjusting for confounding factors such as gender, systolic blood pressure, and fasting blood glucose, the HRs (95%) for diabetes mellitus in each age group were 3.992 (1.897, 8.400), 2.321 (1.589, 3.392), 2.041 (1.667, 2.500), 2.007 (1.708, 2.360), and 1.908 (1.570, 2.319), and the differences were statistically significant (＜0.001). Newly developed NAFLD is an independent risk factor for new-onset diabetes mellitus. Early exposure to NAFLD increases the risk of developing diabetes mellitus compared with the same age group. Younger age of onset of NAFLD should be given attention and active treatment.
探讨不同发病年龄的非酒精性脂肪肝（NAFLD）与新发糖尿病的关系。在开滦集团公司开展队列研究。以在职和退休员工为研究对象。排除基线时诊断为NAFLD、既往糖尿病史及长期大量饮酒史后，最终纳入队列43317例。研究对象按年龄分为五组（<30岁为第1组，30 - 39岁为第2组，40 - 49岁为第3组，50 - 59岁为第4组，≥60岁为第5组）。比较各NAFLD组与非脂肪肝人群组新发糖尿病的患病率和发病密度。采用多因素Cox回归模型分析不同发病年龄的NAFLD与新发糖尿病的关系。采用单因素方差分析、检验或多因素Cox回归模型进行统计分析。NAFLD组糖尿病的患病率和发病密度显著高于非脂肪肝人群。不同年龄组糖尿病的患病率分别为6.45%、6.88%、9.94%、10.83%和11.43%。各年龄组的发病密度分别为9.21/1000人年、11.10/1000人年、16.17/1000人年、18.72/1000人年和22.13/1000人年，差异有统计学意义（<0.001）。多因素Cox回归模型结果显示，校正性别、收缩压和空腹血糖等混杂因素后，各年龄组糖尿病的HR（95%）分别为3.992（1.897，8.400）、2.321（1.589，3.392）、2.041（1.667，2.500）、2.007（1.708，2.360）和1.908（1.570, 2.319），差异有统计学意义（＜0.001）。新发NAFLD是新发糖尿病的独立危险因素。与同年龄组相比，早期暴露于NAFLD会增加患糖尿病的风险。NAFLD发病年龄越小越应引起重视并积极治疗。
