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降低糖尿病风险饮食与慢性肝病死亡率之间的关联。

Association Between a Diabetes Risk Reduction Diet and Mortality From Chronic Liver Disease.

作者信息

Shaukat Momna, Khalid Malik Nouman, Aslam Hasan Shujah, Sidra Hafiza, Bashir Abadullah Sajid, Tariq Sania, Partab Fnu, Shweta Fnu

机构信息

Nephrology, Pakistan Kidney and Liver Institute, Lahore, PAK.

Medicine, Habib Hospital, Mandi Bahauddin, PAK.

出版信息

Cureus. 2025 Jul 1;17(7):e87111. doi: 10.7759/cureus.87111. eCollection 2025 Jul.

Abstract

BACKGROUND

Chronic liver disease (CLD) is a major global health concern, closely linked with metabolic disorders such as obesity and type 2 diabetes mellitus (T2DM).

OBJECTIVE

To examine the association between adherence to a Diabetes Risk Reduction Diet (DRRD) and mortality from CLD in a prospective adult cohort.

METHODS

This prospective cohort study was conducted at the Pakistan Kidney and Liver Institute, Lahore, Pakistan, and the DHQ (District Headquarter) Hospital, Bagh, AJK, Pakistan, from January 2023 to June 2023. Data were collected from a large, population-based health and nutrition survey that incorporated detailed dietary intake assessments, clinical parameters, and long-term mortality follow-up. Participants were enrolled at baseline and followed over time to observe liver-specific mortality outcomes. A total of 435 adult participants were included in the study. Participants aged more than 18 years with complete dietary data, as well as relevant clinical and demographic information, were included.

RESULTS

During the follow-up period, 48 liver-related deaths were recorded. Participants in the highest DRRD adherence tertile had a significantly lower risk of CLD mortality (adjusted HR (hazard ratio) 0.31; 95% CI (confidence interval): 0.13-0.72; p = 0.006) compared to the lowest tertile. A dose-response trend was observed (p < 0.001). Sensitivity analyses excluding diabetic participants yielded consistent findings. High DRRD adherence was also associated with lower ALT levels and healthier baseline profiles.

CONCLUSION

High adherence to a DRRD is significantly associated with reduced mortality from CLD. These findings underscore the potential of metabolic-focused dietary interventions in mitigating liver-related outcomes.

摘要

背景

慢性肝病(CLD)是全球主要的健康问题,与肥胖和2型糖尿病(T2DM)等代谢紊乱密切相关。

目的

在一个前瞻性成人队列中研究坚持糖尿病风险降低饮食(DRRD)与CLD死亡率之间的关联。

方法

这项前瞻性队列研究于2023年1月至2023年6月在巴基斯坦拉合尔的巴基斯坦肾脏和肝脏研究所以及巴基斯坦阿扎德克什米尔地区巴格的地区总部医院(DHQ医院)进行。数据收集自一项基于人群的大型健康和营养调查,该调查纳入了详细的饮食摄入量评估、临床参数和长期死亡率随访。参与者在基线时入组,并随时间进行随访以观察肝脏特异性死亡率结果。该研究共纳入435名成年参与者。纳入年龄超过18岁且有完整饮食数据以及相关临床和人口统计学信息的参与者。

结果

在随访期间,记录了48例肝脏相关死亡。与最低三分位数相比,DRRD依从性最高三分位数的参与者CLD死亡风险显著降低(调整后风险比(HR)为0.31;95%置信区间(CI):0.13 - 0.72;p = 0.006)。观察到剂量反应趋势(p < 0.001)。排除糖尿病参与者的敏感性分析得出了一致的结果。高DRRD依从性还与较低的ALT水平和更健康的基线特征相关。

结论

高坚持DRRD与CLD死亡率降低显著相关。这些发现强调了以代谢为重点的饮食干预在减轻肝脏相关结局方面的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dc4/12312776/2bf56acb2ced/cureus-0017-00000087111-i01.jpg

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