开始他汀类药物治疗的患者中脂肪肝指数与新发糖尿病风险的关联：一项6年回顾性研究

Association of Fatty Liver Index with Incident Diabetes Risk in Patients Initiating Statin-Therapy: A 6-Year Retrospective Study.

作者信息

Anastasiou Georgia, Liberopoulos Evangelos, Petkou Ermioni, Koutsogianni Amalia Despoina, Adamidis Petros Spyridwnas, Liamis George, Ntzani Evangelia, Barkas Fotios

机构信息

Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece.

1st Propaedeutic Department of Medicine, Laiko General Hospital of Athens, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece.

出版信息

Diagnostics (Basel). 2023 Jan 30;13(3):503. doi: 10.3390/diagnostics13030503.

DOI:10.3390/diagnostics13030503

PMID:36766607

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9913972/

Abstract

BACKGROUND

Statins are associated with new-onset type 2 diabetes (T2D), mainly in patients with metabolic syndrome (MetS). The fatty liver index (FLI) is used as a prognostic score for the diagnosis of non-alcoholic fatty liver disease (NAFLD), which is common in patients with MetS. We aimed to investigate the association of FLI with new-onset T2D in patients initiating statin therapy.

METHODS

A retrospective observational study including 1241 individuals with dyslipidemia and followed up for ≥3 years. Patients with T2D and those receiving lipid-lowering treatment at the baseline visit were excluded. Models with clinical and laboratory parameters were used to assess the association of FLI with incident T2D.

RESULTS

Among the 882 eligible subjects, 11% developed T2D during the follow-up (6 years; IQR: 4-10 years). After adjusting for sex, age and MetS parameters, a multivariate analysis revealed that age (HR:1.05; 95%CI: 1.01-1.09, < 0.05), fasting plasma glucose (HR: 1.09; 95%CI: 1.06-1.13, < 0.001) and FLI (HR: 1.02; 95%CI: 1.01-1.04, < 0.01) were independently associated with T2D risk. The subjects with probable NAFLD (FLI ≥ 60) had a three-fold increased T2D risk compared with the subjects with FLI < 60 (HR: 3.14; 95%CI: 1.50-6.59, = 0.001). A ROC curve analysis showed that FLI had a significant, although poor, predictive value for assessing T2D risk (C-Statistic: 0.67; 95%CI: 0.58-0.77, = 0.001). Higher FLI values were associated with reduced T2D-free survival (log-rank = 15.46, < 0.001).

CONCLUSIONS

FLI is significantly and independently associated with new-onset T2D risk in patients initiating statin therapy.

摘要

背景

他汀类药物与新发2型糖尿病（T2D）相关，主要发生在代谢综合征（MetS）患者中。脂肪肝指数（FLI）用作诊断非酒精性脂肪性肝病（NAFLD）的预后评分，NAFLD在MetS患者中很常见。我们旨在研究FLI与开始他汀类药物治疗患者的新发T2D之间的关联。

方法

一项回顾性观察性研究，纳入1241例血脂异常患者，随访时间≥3年。排除基线访视时患有T2D和接受降脂治疗的患者。使用包含临床和实验室参数的模型评估FLI与新发T2D的关联。

结果

在882例符合条件的受试者中，11%在随访期间（6年；四分位间距：4 - 10年）发生了T2D。在调整性别、年龄和MetS参数后，多因素分析显示年龄（风险比：1.05；95%置信区间：1.01 - 1.09，P < 0.05）、空腹血糖（风险比：1.09；95%置信区间：1.06 - 1.13，P < 0.001）和FLI（风险比：1.02；95%置信区间：1.01 - 1.04，P < 0.01）与T2D风险独立相关。与FLI < 60的受试者相比，可能患有NAFLD（FLI≥60）的受试者患T2D的风险增加了两倍（风险比：3.14；95%置信区间：1.50 - 6.59，P = 0.001）。ROC曲线分析显示，FLI对评估T2D风险具有显著但较差的预测价值（C统计量：0.67；95%置信区间：0.58 - 0.77，P = 0.001）。较高的FLI值与无T2D生存期缩短相关（对数秩检验 = 15.46，P < 0.001）。