Department of Internal Medicine II, University Medical Centre Saarland, Homburg, Germany.
Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany.
Sci Rep. 2024 Sep 17;14(1):21650. doi: 10.1038/s41598-024-72105-8.
People with type 2 diabetes mellitus (T2DM) show a high prevalence of steatotic liver disease (SLD), and especially metabolic dysfunction-associated steatotic liver disease (MASLD), with liver fibrosis. Their health-related quality of life (HRQL) is affected by multiple in part overlapping factors and aggravated by metabolic and liver-related comorbidities, including liver fibrosis stage. The aim of this study was to investigate the effect size of advanced fibrosis (AF) on the HRQL in people with T2DM. A total of 149 individuals with T2DM treated at a primary care provider within the German disease management program (DMP) were included in the final analysis. Vibration-controlled transient elastography (VCTE) was used to non-invasively detect steatosis and AF. The EQ-5D-3L questionnaire was used to assess the HRQL. Uni- and multivariable linear regression models were used to identify independent predictors of impaired HRQL. The majority was male (63.1%), and the median age was 67 years (IQR 59; 71). In the entire cohort, the prevalence of MASLD and AF was 70.7% and 19.5%, respectively. People with T2DM and AF had an overall lower HRQL in comparison to those without AF (p < 0.001). Obesity (β: - 0.247; 95% CI - 0.419, - 0.077) and AF (β: - 0.222; 95% CI - 0.383, - 0.051) remained independent predictors of a poor HRQL. In turn, T2DM-related comorbidities were not predictive of an impaired HRQL. Obesity and AF negatively affect the HRQL in patients with SLD and T2DM in primary care. Awareness of liver health and specific interventions may improve patient-reported and liver-related outcomes in people with T2DM.
患有 2 型糖尿病（T2DM）的人患有脂肪性肝病（SLD）的患病率很高，特别是代谢功能障碍相关的脂肪性肝病（MASLD），并伴有肝纤维化。他们的健康相关生活质量（HRQL）受到多种部分重叠因素的影响，并因代谢和肝脏相关合并症而恶化，包括肝纤维化分期。本研究旨在探讨晚期纤维化（AF）对 T2DM 患者 HRQL 的影响大小。共有 149 名在德国疾病管理计划（DMP）中初级保健提供者处接受治疗的 T2DM 患者被纳入最终分析。振动控制瞬态弹性成像（VCTE）用于非侵入性检测脂肪变性和 AF。EQ-5D-3L 问卷用于评估 HRQL。单变量和多变量线性回归模型用于确定 HRQL 受损的独立预测因素。大多数患者为男性（63.1%），中位年龄为 67 岁（IQR 59；71）。在整个队列中，MASLD 和 AF 的患病率分别为 70.7%和 19.5%。与没有 AF 的患者相比，患有 T2DM 和 AF 的患者整体 HRQL 较低（p < 0.001）。肥胖症（β：-0.247；95%CI：-0.419，-0.077）和 AF（β：-0.222；95%CI：-0.383，-0.051）仍然是 HRQL 较差的独立预测因素。反过来，T2DM 相关的合并症并不能预测 HRQL 受损。肥胖症和 AF 会对初级保健中患有 SLD 和 T2DM 的患者的 HRQL 产生负面影响。对肝脏健康和特定干预措施的认识可能会改善 T2DM 患者的患者报告和肝脏相关结局。
