Dehghani Firouzabadi Mohammad, Poopak Amirhossein, Sheikhy Ali, Dehghani Firouzabadi Fatemeh, Moosaie Fatemeh, Rabizadeh Soghra, Momtazmanesh Sara, Nakhjavani Manouchehr, Esteghamati Alireza
Endocrinology and Metabolism Research Center (EMRC) Vali-Asr Hospital Tehran University of Medical Sciences, Tehran, Iran.
Department of Radiology and Imaging Sciences Clinical Center National Institutes of Health, Bethesda, USA.
Int J Endocrinol. 2024 Jun 26;2024:5328965. doi: 10.1155/2024/5328965. eCollection 2024.
METHODS AND RESULTS: In this prospective cohort study, 1197 patients with type 2 diabetes (T2D) were divided into two groups (360 patients with NAFLD and 847 without NAFLD) and were followed for a median of 5 years for the incidence of CVD. Cox regression analysis was used to assess the association between NAFLD, liver enzyme level, aspartate aminotransferase to platelet ratio index (APRI), and the incidence risk of CVD and its subgroups (i.e., myocardial infarction, chronic heart disease, coronary artery bypass grafting, and percutaneous coronary intervention). There was a significant positive association between CVD incidence and NAFLD (HR = 1.488, 95% CI = 1.041-2.124, value = 0.029). Although patients with NAFLD had higher levels of ALT and AST levels ( value = <0.001), there was no significant association between liver enzymes and the incidence risk of CVD when adjusted for different variables. Furthermore, NAFLD was associated with NAFLD APRI (2), APRI (3), and APRIQ (4) (1.365 (1.046-1.781), 1.623 (1.234-2.135), and 3.373 (2.509-4.536)), respectively. CONCLUSION: NAFLD increased the incidence risk of CVD in T2D. However, there was no association between liver enzymes (ALT, AST, ALK-P, and GGT) and a higher incidence risk of CVD in T2D when adjusted for confounding variables.
方法与结果：在这项前瞻性队列研究中，1197例2型糖尿病（T2D）患者被分为两组（360例非酒精性脂肪性肝病患者和847例无非酒精性脂肪性肝病患者），并随访5年以观察心血管疾病（CVD）的发病率。采用Cox回归分析评估非酒精性脂肪性肝病、肝酶水平、天冬氨酸氨基转移酶与血小板比值指数（APRI）与CVD及其亚组（即心肌梗死、慢性心脏病、冠状动脉搭桥术和经皮冠状动脉介入治疗）发病风险之间的关联。CVD发病率与非酒精性脂肪性肝病之间存在显著正相关（HR = 1.488，95%CI = 1.041 - 2.124，P值 = 0.029）。尽管非酒精性脂肪性肝病患者的ALT和AST水平较高（P值 = <0.001），但在调整不同变量后，肝酶与CVD发病风险之间无显著关联。此外，非酒精性脂肪性肝病分别与APRI（2）、APRI（3）和APRIQ（4）相关（分别为1.365（1.046 - 1.781）、1.623（1.234 - 2.135）和3.373（2.509 - 4.536））。 结论：非酒精性脂肪性肝病增加了T2D患者CVD的发病风险。然而，在调整混杂变量后，肝酶（ALT、AST、碱性磷酸酶和γ-谷氨酰转移酶）与T2D患者较高的CVD发病风险之间无关联。
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