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2型糖尿病成人患者中MAFLD的患病率及相关因素

Prevalence and associated factors of MAFLD in adults with type 2 diabetes.

作者信息

He Yifei, Xiao Feng, Yi Bin, Lu Jin

机构信息

Department of Endocrinology, Changhai Hospital, Naval Medical University, Shanghai, People's Republic of China.

Department of Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, People's Republic of China.

出版信息

PLOS Glob Public Health. 2024 Dec 30;4(12):e0003572. doi: 10.1371/journal.pgph.0003572. eCollection 2024.

DOI:10.1371/journal.pgph.0003572
PMID:39775020
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11684647/
Abstract

To estimate the prevalence and associated factors of hepatic steatosis and fibrosis in adults with type 2 diabetes (T2DM) in the United States.Data were retrieved from the 2017‒March 2020 prepandemic cycle of the National Health and Nutritional Examination and Survey (NHANES). The study population included patients with T2DM. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were used to assess hepatic steatosis and fibrosis, respectively. A total of 1,290 T2DM patients were included, 85.2% (1044 patients) of whom presented with hepatic steatosis (CAP>248 dB/m). Among the 1044 T2DM patients with metabolically associated fatty liver disease (MAFLD), 29.5% developed hepatic fibrosis (LSM>8 kPa). Non-Hispanic black individuals (adjusted OR = 0.4008), BMI (adjusted OR = 1.1627), HbA1c (adjusted OR = 1.1450), TG (adjusted OR = 1.2347), HDL (adjusted OR = 0.4981), ALT (adjusted OR = 1.0227), AST (adjusted OR = 0.9396), and albumin (adjusted OR = 1.7030) were independently associated with steatosis. Age (adjusted OR = 1.0300), female sex (adjusted OR = 0.6655), BMI (adjusted OR = 1.1324), AST (adjusted OR = 1.0483), and GGT (adjusted OR = 1.0101) were independently associated with fibrosis. Heart failure was an independent factor associated with advanced fibrosis (adjusted OR = 1.9129) and cirrhosis (adjusted OR = 2.228). In the United States, hepatic steatosis is highly prevalent among T2DM patients, with 29.5% of these patients developing hepatic fibrosis. Some components of metabolic syndrome are related to hepatic steatosis and fibrosis. Moreover, heart failure is an independent factor associated with advanced fibrosis and cirrhosis.

摘要

评估美国2型糖尿病（T2DM）成人患者肝脂肪变性和肝纤维化的患病率及相关因素。数据来自2017年至2020年3月大流行前周期的美国国家健康与营养检查调查（NHANES）。研究人群包括T2DM患者。分别使用受控衰减参数（CAP）和肝脏硬度测量（LSM）来评估肝脂肪变性和肝纤维化。共纳入1290例T2DM患者，其中85.2%（1044例患者）存在肝脂肪变性（CAP>248 dB/m）。在1044例患有代谢相关脂肪性肝病（MAFLD）的T2DM患者中，29.5%发生了肝纤维化（LSM>8 kPa）。非西班牙裔黑人个体（校正OR = 0.4008）、体重指数（BMI）（校正OR = 1.1627）、糖化血红蛋白（HbA1c）（校正OR = 1.1450）､甘油三酯（TG）（校正OR = 1.2347）、高密度脂蛋白（HDL）（校正OR = 0.4981）、谷丙转氨酶（ALT）（校正OR = 1.0227）、谷草转氨酶（AST）（校正OR = 0.9396）和白蛋白（校正OR = 1.7030）与脂肪变性独立相关。年龄（校正OR = 1.0300）、女性（校正OR = 0.6655）、BMI（校正OR = 1.132 4）、AST（校正OR = 1.0483）和γ-谷氨酰转移酶（GGT）（校正OR = 1.0101）与纤维化独立相关。心力衰竭是与晚期纤维化（校正OR = 1.9129）和肝硬化（校正OR = 2.228）相关的独立因素。在美国，肝脂肪变性在T2DM患者中非常普遍，其中29.5%的患者发生了肝纤维化。代谢综合征的一些组分与肝脂肪变性和肝纤维化有关。此外，心力衰竭是与晚期纤维化和肝硬化相关的独立因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b9c/11684647/90b77b645901/pgph.0003572.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b9c/11684647/640bf6f74577/pgph.0003572.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b9c/11684647/90b77b645901/pgph.0003572.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b9c/11684647/640bf6f74577/pgph.0003572.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b9c/11684647/90b77b645901/pgph.0003572.g002.jpg

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引用本文的文献

[1]
Cardiovascular implications of metabolic dysfunction-associated fatty liver disease and type 2 diabetes mellitus: A meta-analysis.

World J Hepatol. 2025-5-27

本文引用的文献

[1]
Associations of advanced liver fibrosis with heart failure with preserved ejection fraction in type 2 diabetic patients according to obesity and metabolic goal achievement status.

Front Endocrinol (Lausanne). 2023

[2]
Global prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus: an updated systematic review and meta-analysis.

Gut. 2023-11

[3]
EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update.

J Hepatol. 2021-9

[4]
Prevalence and factors associated with NAFLD detected by vibration controlled transient elastography among US adults: Results from NHANES 2017-2018.

PLoS One. 2021

[5]
Role of Insulin Resistance in MAFLD.

Int J Mol Sci. 2021-4-16

[6]
Blood pressure, glycemic status and advanced liver fibrosis assessed by transient elastography in the general United States population.

J Hypertens. 2021-8-1

[7]
Factors associated with the Severity of Findings on Hepatic Transient Elastography among Persons with Type 2 Diabetes and Fatty Liver.

J ASEAN Fed Endocr Soc. 2019

[8]
Congestive Hepatopathy.

Int J Mol Sci. 2020-12-10

[9]
High Prevalence of Advanced Liver Fibrosis Assessed by Transient Elastography Among U.S. Adults With Type 2 Diabetes.

Diabetes Care. 2021-2

[10]
Monitoring Occurrence of Liver-Related Events and Survival by Transient Elastography in Patients With Nonalcoholic Fatty Liver Disease and Compensated Advanced Chronic Liver Disease.

Clin Gastroenterol Hepatol. 2021-4

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