Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Diabetes Obes Metab. 2024 Jan;26(1):180-190. doi: 10.1111/dom.15304. Epub 2023 Oct 23.
This study aimed to investigate the effects of repeated detection of non-alcoholic fatty liver disease (NAFLD) on the incidence risk of type 2 diabetes in young adults.
In this nationwide population-based observational study using data from the Korean National Health Insurance Service, approximately 1 125 015 young adults aged 20-39 years who underwent health screening four times between 2009 and 2013 were included. NAFLD was defined as a fatty liver index (FLI) of ≥60. Repeated detection of NAFLD scores was defined as the number of times the participants met the criteria for NAFLD (0-4). To account for the degree of repeated detection of NAFLD, weighted repeated NAFLD scores were scaled as a sum by assigning points (0 points for FLI <30, 1 point for 30 ≤ FLI < 60, and 2 points for FLI ≥60) ranging from 0 to 8 points.
The multivariable-adjusted hazard ratios of type 2 diabetes associated with repeated detection of NAFLD scores of 1, 2, 3 and 4 were 2.74 (95% confidence interval 2.57-2.921), 3.45 (3.221-3.694), 4.588 (4.303-4.892) and 6.126 (5.77-6.504), respectively. The incidence risk of type 2 diabetes increased significantly with repeated detection of the NAFLD score. In the analysis of the weighted repeated NAFLD score, the hazard ratios for the incidence of type 2 diabetes showed a significant continuous positive linear association with increasing scores.
Repeated detection of NAFLD influenced the incidence risk of type 2 diabetes in young adults, and a higher degree of repeated detection of NAFLD was independently associated with the risk of type 2 diabetes in young adults.
本研究旨在探讨非酒精性脂肪肝（NAFLD）的反复检出对年轻成年人 2 型糖尿病发病风险的影响。
本研究采用韩国国家健康保险服务的数据，进行了一项全国性的基于人群的观察性研究，共纳入了约 1125015 名年龄在 20-39 岁之间、在 2009 年至 2013 年期间接受了四次健康筛查的年轻人。NAFLD 的定义为脂肪性肝病指数（FLI）≥60。NAFLD 评分的反复检出定义为参与者符合 NAFLD 标准的次数（0-4 次）。为了考虑到 NAFLD 反复检出的程度，通过分配分数（FLI<30 为 0 分，30≤FLI<60 为 1 分，FLI≥60 为 2 分）将加权重复的 NAFLD 评分加总为 0-8 分。
多变量调整后的 2 型糖尿病发病风险与重复检出的 NAFLD 评分 1、2、3 和 4 分相关的风险比分别为 2.74（95%置信区间 2.57-2.921）、3.45（3.221-3.694）、4.588（4.303-4.892）和 6.126（5.77-6.504）。2 型糖尿病的发病风险随 NAFLD 评分的反复检出而显著增加。在加权重复 NAFLD 评分分析中，2 型糖尿病发病的风险比与评分的增加呈显著正线性关联。
NAFLD 的反复检出影响了年轻成年人 2 型糖尿病的发病风险，并且较高程度的 NAFLD 反复检出与年轻成年人 2 型糖尿病的风险独立相关。
