非肥胖型非酒精性脂肪性肝病（NAFLD）在 2 型糖尿病患者中的心血管代谢风险特征并不优于肥胖型非酒精性脂肪性肝病。
Non-obese NAFLD had no better cardio-metabolic risk profile than obese NAFLD in type 2 diabetic patients.
机构信息
Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, China.
Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China.
出版信息
Cardiovasc Diabetol. 2022 Oct 14;21(1):210. doi: 10.1186/s12933-022-01648-9.
BACKGROUND
Non-obese non-alcoholic fatty liver disease (NAFLD) has been reported to share clinical outcomes with its obese counterpart in the general population. However, conflicting results have been observed regarding the cardio-metabolic risk profile of non-obese NAFLD as compared to obese NAFLD. Moreover, in the context of type 2 diabetes mellitus (T2DM), this issue has been even less addressed. We hence aimed to examine the association of NAFLD with the cardio-metabolic risk profile in patients with T2DM according to their obesity status.
METHODS
A total of 2,708 patients with T2DM who were hospitalized between June 2018 and May 2021 were cross-sectionally assessed.
RESULTS
The prevalence of NAFLD was 49.3%. NAFLD was found in 34.1% of non-obese patients and 66.0% of obese patients. Non-obese NAFLD patients had more and worse metabolic disorders than obese patients without NAFLD in both men and women. Comparable cardio-metabolic risk profiles were noted between non-obese and obese NAFLD subjects. The associations of worse cardio-metabolic risk profiles with NAFLD were overall stronger in non-obese than in obese subjects among women with T2DM, while more pronounced in obese than in non-obese subjects among men with T2DM.
CONCLUSION
In patients with T2DM, non-obese NAFLD had no better cardio-metabolic risk profile than obese NAFLD. The associations of metabolic disorders with NAFLD were stronger in non-obese than in obese patients in women patients with T2DM.
背景
非肥胖非酒精性脂肪性肝病（NAFLD）在普通人群中与肥胖型 NAFLD 具有相似的临床结局。然而，与肥胖型 NAFLD 相比，非肥胖型 NAFLD 的心血管代谢风险特征存在相互矛盾的结果。此外，在 2 型糖尿病（T2DM）的背景下，这一问题的研究较少。因此，我们旨在根据肥胖状况，研究 T2DM 患者中 NAFLD 与心血管代谢风险特征的相关性。
方法
共纳入 2018 年 6 月至 2021 年 5 月期间住院的 2708 例 T2DM 患者进行横断面评估。
结果
NAFLD 的患病率为 49.3%。非肥胖患者中 NAFLD 的患病率为 34.1%，肥胖患者中 NAFLD 的患病率为 66.0%。在男性和女性中，非肥胖型 NAFLD 患者的代谢紊乱更为严重，而非肥胖型 NAFLD 患者的代谢紊乱比肥胖患者更为严重。在非肥胖和肥胖的 NAFLD 患者中，均发现心血管代谢风险特征相似。在女性 T2DM 患者中，非肥胖型 NAFLD 与较差的心血管代谢风险特征的相关性总体上强于肥胖型 NAFLD 患者，而在男性 T2DM 患者中，肥胖型 NAFLD 与较差的心血管代谢风险特征的相关性则更为明显。
结论
在 T2DM 患者中，非肥胖型 NAFLD 的心血管代谢风险特征并不优于肥胖型 NAFLD。在女性 T2DM 患者中，非肥胖型 NAFLD 与代谢紊乱的相关性强于肥胖型 NAFLD 患者，而在男性 T2DM 患者中，肥胖型 NAFLD 与代谢紊乱的相关性则更为明显。
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