成人非酒精性脂肪肝与2型糖尿病发病关系的前瞻性队列研究

发布时间：2018-02-27 15:17

本文关键词： 脂肪肝糖尿病型发病率队列研究　出处：《中国全科医学》2015年28期 　论文类型：期刊论文

【摘要】：目的探讨成人非酒精性脂肪肝(NAFLD)与2型糖尿病(T2DM)发病的关系。方法以南京市三所医院(东南大学附属中大医院、江苏省老年医院、南京市职业病防治院)体检职工人群为前瞻性研究随访队列,2008年基线调查其一般资料、既往病史、吸烟、饮酒、身体活动情况及体检资料等,2009—2012年连续随访4年,以首次诊断为T2DM为观察终点。将资料完整并符合要求的2 464例体检职工纳入分析,其中男1 445例,女1 019例。根据基线B超检查和饮酒情况将体检职工分为NAFLD组(n=365例)和对照组(n=2 099例)。采用COX比例风险回归模型分析NAFLD与T2DM发病风险的关系。结果经过平均3.8年的随访(9 695人年,其中NAFLD组1 397人年,对照组8 298人年),共有32例发生T2DM,累积发病率为3.30/1 000人年。其中NAFLD组中有12例发生T2DM,累积发病率为8.59/1 000人年;对照组中有20例发生T2DM,累积发病率为2.41/1 000人年。Kaplan-Meier分析显示,两组累积发病率间差异有统计学意义(χ2=21.374,P0.001)。调整年龄、性别、教育程度、家庭收入、吸烟、饮酒、糖尿病家族史、手术史、每日身体活动量、空腹血糖(FBG)、总胆固醇(TC)、丙氨酸氨基转移酶(ALT)、血尿酸(BUA)及体质指数(BMI)后,与对照组相比,NAFLD组发生T2DM的HR(95%CI)为2.936(1.380,6.247)。结论 NAFLD会增加T2DM的发病风险,是T2DM的独立危险因素。为减少糖尿病发生,成年人应重视和积极治疗NAFLD。
[Abstract]:Objective to investigate the relationship between NAFLDD and T2DM in adult patients with type 2 diabetes mellitus. Methods three hospitals (affiliated Chinese University Hospital of Southeast University, Jiangsu Province) were used in this study. In 2008, the general data, past medical history, smoking, drinking, physical activity and physical examination data of the workers were followed up for 4 consecutive years in 2009-2012. With the first diagnosis of T2DM as the observation end point, 2 464 medical examination workers, including 1 445 males, were included in the analysis. 1 019 women were divided into NAFLD group (n = 365) and control group (n = 2099) according to baseline B-ultrasound examination and alcohol consumption. The relationship between NAFLD and risk of T2DM was analyzed by using COX proportional risk regression model. Results after an average of 3.8 years, the risk of T2DM was analyzed by using COX proportional risk regression model. Was followed up for 9,695 person-years, Among them, there were 1397 person years in NAFLD group and 8 298 in control group. There were 32 cases of T2DM, the cumulative incidence rate was 3.30 / 1 000 person-years, among which 12 cases in NAFLD group had T2DM.The cumulative incidence rate was 8.59 / 1 000 person-years. There were 20 cases with T2DMin in the control group. Kaplan-Meier analysis showed that the cumulative incidence of T2DMwas 2.41% / 1 000 person-years. Kaplan-Meier analysis showed that there was a significant difference between the two groups (蠂 2, 21.374, P 0.001. Adjusted age, sex, education, family income, smoking, alcohol consumption, family history of diabetes. After operation history, daily physical activity, fasting blood glucose (FBG), total cholesterol (TC), alanine aminotransferase (alt), serum uric acid (BUAA) and body mass index (BMI), compared with the control group, the HRN 95CI of T2DM in NAFLD group was 2.936 61.3806.2470.Conclusion NAFLD can increase the risk of T2DM. It is an independent risk factor for T2DM. In order to reduce the incidence of diabetes, adults should pay attention to and actively treat NAFLD.
【作者单位】：东南大学附属中大医院消化科;江苏省老年医院干部科;江苏建康职业学院公共卫生教研室;南京市职业病防治院职业健康管理中心;
【分类号】：R575;R587.1

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