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Atherogenic dyslipidemia, but not hyperglycemia, is an independent factor associated with liver fibrosis in subjects with type 2 diabetes and NAFLD: a population-based study.

动脉粥样硬化性血脂异常,而不是高血糖,是2型糖尿病和NAFLD患者肝纤维化的独立相关因素: 一项基于人群的研究。

  • 影响因子:5.04
  • DOI:10.1530/EJE-20-1240
  • 作者列表:"Julián MT","Pera G","Soldevila B","Caballería L","Julve J","Puig-Jové C","Morillas R","Torán P","Expósito C","Puig-Domingo M","Castelblanco E","Franch-Nadal J","Cusi K","Mauricio D","Alonso N
  • 发表时间:2021-04-01
Abstract

Objective:To investigate the prevalence and risks factors associated with the presence of liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD) with and without type 2 diabetes mellitus (T2D). Design and methods:This study was part of a population-based study conducted in the Barcelona metropolitan area among subjects aged 18-75 years old. Secondary causes of steatosis were excluded. Moderate-to-advanced liver fibrosis was defined as a liver stiffness measurement (LSM) ≥ 8.0 kPa assessed by transient elastography. Results:Among 930 subjects with NAFLD, the prevalence of moderate-to-advanced liver fibrosis was higher in subjects with T2D compared those without (30.8% vs 8.7%). By multivariable analysis, one of the main factors independently associated with increased LSM in subjects with NAFLD was atherogenic dyslipidemia but only in those with T2D. The percentage of subjects with LSM ≥ 8.0 kPa was higher in subjects with T2D and atherogenic dyslipidemia than in those with T2D without atherogenic dyslipidemia both for the cut-off point of LSM ≥8.0 kPa (45% vs 24% P = 0.002) and ≥13 kPa (13% vs 4% P = 0.020). No differences were observed in the prevalence of LSM ≥8.0 kPa regarding glycemic control among NAFLD-diabetic subjects. Conclusions:Factors associated with moderate-to-advanced liver fibrosis in NAFLD are different in subjects with and without T2D. Atherogenic dyslipidemia was associated with the presence of moderate-to-advanced liver fibrosis in T2D with NAFLD but not in non-diabetic subjects. These findings highlight the need for an active search for liver fibrosis in subjects with T2D NAFLD and atherogenic dyslipidemia.

摘要

目的: 探讨伴或不伴2型糖尿病 (T2D) 的非酒精性脂肪性肝病 (NAFLD) 患者肝纤维化的患病率及危险因素。 设计和方法: 本研究是在巴塞罗那大都市区对18-75岁的受试者进行的基于人群的研究的一部分。排除继发性原因的脂肪变性。中度至晚期肝纤维化定义为通过瞬时弹性成像评估的肝硬度测量值 (LSM) ≥ 8.0 kPa。 结果: 在930名NAFLD受试者中,T2D受试者的中度至晚期肝纤维化患病率高于无T2D受试者 (30.8% vs 8.7%)。通过多变量分析,NAFLD受试者中与LSM增加独立相关的主要因素之一是动脉粥样硬化性血脂异常,但仅在T2D患者中。对于LSM ≥ 8.0 kPa (8.0 vs 45% P = 24%) 和 ≥ 13 kPa (0.002 vs 13% P = 4%) 的分界点,患有T2D和致动脉粥样硬化性血脂异常的受试者中LSM ≥ 0.020 kPa的受试者百分比高于患有T2D而无致动脉粥样硬化性血脂异常的受试者。在NAFLD-糖尿病受试者中,在血糖控制方面,LSM ≥ 8.0 kPa的患病率没有观察到差异。 结论: 在患有T2D和不患有T2D的受试者中,NAFLD的中度至晚期肝纤维化的相关因素是不同的。动脉粥样硬化性血脂异常与T2D伴NAFLD患者的中度至晚期肝纤维化的存在相关,但在非糖尿病受试者中不相关。这些发现强调了在患有T2D NAFLD和动脉粥样硬化性血脂异常的受试者中积极寻找肝纤维化的必要性。

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影响因子:2.68
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DOI:10.1080/14656566.2020.1814255
作者列表:["Sawada H","Oeda T","Kohsaka M","Tomita S","Umemura A","Park K","Yamamoto K","Kiyohara K"]

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发表时间:2021-03-24
DOI:10.1007/s11033-021-06299-9
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