超重个体中肝脂肪变性、纤维化与2型糖尿病发病之间的关联：意大利南部一项基于FibroScan的研究

Association between liver steatosis, fibrosis, and the onset of type 2 diabetes in overweight individuals: A fibroscan-based study in Southern Italy.

作者信息

Guido Davide, Cerabino Nicole, Di Chito Martina, Di Stasi Vincenza, De Nucci Sara, Shahini Endrit, Giannuzzi Vito, Cozzolongo Raffaele, Coletta Sergio, Stabile Dolores, Ancona Anna, Longo Giovanna, Fontana Luigi, Giannelli Gianluigi, De Pergola Giovanni

机构信息

Unit of Data Science, National Institute of Gastroenterology "Saverio de Bellis", IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy.

Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, 70013 Bari, Italy.

出版信息

Diabetes Res Clin Pract. 2024 Dec;218:111911. doi: 10.1016/j.diabres.2024.111911. Epub 2024 Nov 7.

DOI:10.1016/j.diabres.2024.111911

PMID:39521438

Abstract

OBJECTIVE

This study aims to explore the association between liver steatosis and fibrosis, as assessed by Fibroscan, and the onset of type 2 diabetes in overweight, medication-free men and women.

METHODS

We analyzed data from 164 participants with overweight or obesity (41.4 % male), including 39 individuals (23.8 %) with type 2 diabetes. All participants underwent Fibroscan to evaluate liver steatosis (CAP > 275 dBm) and fibrosis (liver stiffness > 8.2 kPa). Diabetes was diagnosed using fasting glucose, 2-hour glucose tolerance test (OGTT), and HbA1c levels.

RESULTS

Liver steatosis was significantly more prevalent in individuals with diabetes (89.7 % vs 52 %, P < 0.001). Liver fibrosis was observed in 35.9 % of subjects with diabetes (vs 13.6 %, P = 0.002). Mean CAP (P < 0.001) and kPA (P = 0.006) values were significantly higher in the group with diabetes. Significant associations between CAP (MD: 30.87, P = 0.009) and liver stiffness (MD: 2.454, P = 0.006) with diabetes were found, independent of other variables. Additionally, liver steatosis was independently associated with elevated HOMA-IR levels (P = 0.001).

CONCLUSION

Elevated liver steatosis and fibrosis are both linked to type 2 diabetes, independent of traditional risk factors. These findings support screening for diabetes in individuals with significant steatosis and fibrosis and vice versa.

摘要

目的

本研究旨在探讨通过Fibroscan评估的肝脏脂肪变性和纤维化与超重且未服用药物的男性和女性2型糖尿病发病之间的关联。

方法

我们分析了164名超重或肥胖参与者（41.4%为男性）的数据，其中包括39名2型糖尿病患者（23.8%）。所有参与者均接受Fibroscan检查以评估肝脏脂肪变性（受控衰减参数>275 dBm）和纤维化（肝脏硬度>8.2 kPa）。糖尿病通过空腹血糖、2小时葡萄糖耐量试验（OGTT）和糖化血红蛋白水平进行诊断。

结果

糖尿病患者中肝脏脂肪变性的患病率显著更高（89.7%对52%，P<0.001）。35.9%的糖尿病患者存在肝纤维化（相比之下为13.6%，P = 0.002）。糖尿病组的平均受控衰减参数（P<0.001）和千帕值（P = 0.006）显著更高。发现受控衰减参数（平均差：30.87，P = 0.009）和肝脏硬度（平均差：2.454，P = 0.006）与糖尿病之间存在显著关联，且独立于其他变量。此外，肝脏脂肪变性与升高的胰岛素抵抗稳态模型评估水平独立相关（P = 0.001）。