非酒精性脂肪性肝病与 2 型糖尿病的风险增加有关。

Non-alcoholic fatty liver disease is associated with an increased risk of type 2 diabetes.

机构信息

Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf.

Department of Surgery (A), University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, Duesseldorf.

出版信息

Eur J Gastroenterol Hepatol. 2023 Jun 1;35(6):662-667. doi: 10.1097/MEG.0000000000002555. Epub 2023 Apr 15.

DOI:10.1097/MEG.0000000000002555

PMID:37115964

Abstract

OBJECTIVE

Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease worldwide and represents the leading cause of liver-related morbidity and mortality. Its all-cause mortality is often driven by co-existing metabolic diseases such as type 2 diabetes (T2DM), which share many pathophysiological characteristics. The risk of developing T2DM among NAFLD patients in Germany is only poorly described.

METHODS

A cohort of 17 245 NAFLD patients and a propensity score-matched cohort of equal size were identified from the Disease Analyzer database (IQVIA) between 2005 and 2020. The incidence of T2DM was evaluated as a function of NAFLD during a 5-year study period using Cox-regression models.

RESULTS

Within 5 years of the index date, 18.8% and 11.7% of individuals with and without NAFLD were diagnosed with T2DM ( P < 0.001). Regression analysis revealed a hazard ratio of 1.77 [95% confidence interval (CI), 1.68-1.88] for the development of T2DM among NAFLD patients. Subgroup analyses confirmed this association for all age groups (18-50, 51-60, 61-70 and >70 years), male and female patients, as well as normal weight (BMI < 25 kg/m 2 ), overweighted (BMI 25-30 kg/m 2 ) and obese (BMI > 30 kg/m 2 ) patients.

CONCLUSION

Our data revealed a significantly increased incidence of T2DM among NAFLD patients in Germany. Given the dramatically increasing global relevance of NAFLD, we believe that prevention and regular screening programs for T2DM in NAFLD patients could help to reduce its high mortality and morbidity in the future.

摘要

目的

非酒精性脂肪性肝病（NAFLD）已成为全球最常见的肝病，也是导致与肝脏相关的发病率和死亡率的主要原因。其全因死亡率通常由 2 型糖尿病（T2DM）等共存代谢性疾病驱动，这些疾病具有许多共同的病理生理特征。德国 NAFLD 患者发生 T2DM 的风险描述甚少。

方法

在 2005 年至 2020 年期间，使用 IQVIA 的 Disease Analyzer 数据库，我们确定了 17245 名 NAFLD 患者的队列和大小相等的倾向评分匹配队列。使用 Cox 回归模型，在 5 年的研究期间评估了 NAFLD 对 T2DM 发病的影响。

结果

在指数日期后的 5 年内，有 NAFLD 和无 NAFLD 的个体分别有 18.8%和 11.7%被诊断为 T2DM（P<0.001）。回归分析显示，NAFLD 患者发展为 T2DM 的风险比为 1.77（95%置信区间，1.68-1.88）。亚组分析证实了所有年龄组（18-50 岁、51-60 岁、61-70 岁和>70 岁）、男性和女性患者以及正常体重（BMI<25kg/m2）、超重（BMI 25-30kg/m2）和肥胖（BMI>30kg/m2）患者中存在这种关联。