Nutr Metab Cardiovasc Dis:有脂肪肝?瘦子也要谨防糖尿病!

2019-02-15 国际糖尿病编辑部 国际糖尿病

根据发表于Nutrition, Metabolism and Cardiovascular Diseases的一项研究,非酒精性脂肪肝(NAFLD)是非肥胖成人糖尿病发生的独立危险因素。

根据发表于Nutrition, Metabolism and Cardiovascular Diseases的一项研究,非酒精性脂肪肝(NAFLD)是非肥胖成人糖尿病发生的独立危险因素。

虽然NAFLD在肥胖者中经常发生,但越来越明显,NAFLD在非肥胖者中的比例也很大。非肥胖者发生NAFLD的机制尚不明确,但内脏脂肪组织的不同分布、体重增加、高胆固醇饮食的摄入以及遗传背景都被认为是导致非肥胖者发生NAFLD的原因。

韩国江北三星医院的Ki Chul Sung及同事在研究中招募70303例2007~2014年在江北三星医院接受至少2次健康检查的受试者,受试者年龄≥20岁,BMI<25 kg/m2。通过自我管理调查问卷获得这些受试者的病史,腹部超声检查确定脂肪肝,计算每位受试者的胰岛素抵抗和肝纤维化情况。

平均随访3.32年,整个队列中共有852例糖尿病患者(平均年龄40.2岁;33.6%为女性,平均BMI为22.8 kg/m2)。本研究中,糖尿病定义为自我识别为糖尿病、使用降糖药物、 HbA1c≥6.5%或空腹血糖≥126 mg/dl。研究人员注意到,糖尿病风险随着胰岛素抵抗每增加一个四分位数而增加(P<0.001),肝纤维化的最高四分位数也与糖尿病风险增加有关(HR=1.36,95%CI:1.13~1.64)。

单纯脂肪肝的女性或男性患糖尿病的风险均增加(女性:HR=2.86,95%CI:1.5~5.46;男性:HR=2.17;95%CI:1.56~3.03)。脂肪肝合并有胰岛素抵抗者的糖尿病风险增加(女性:HR=6.6,95%CI:3.05~14.27;男性:HR=3.95;95%CI:2.64~5.9)。对于有脂肪肝且肝纤维化和胰岛素抵抗处于最高四分位数的受试者,糖尿病风险尤其在男性增加显著(HR=2.63,95%CI:1.41~4.92),在女性则不显著(HR=1.5,95%CI:0.32~6.95)。

研究人员指出,研究数据表明,无症状受试者有脂肪肝和胰岛素抵抗,即使为非肥胖个体,其糖尿病风险也增加。如果适当的话,这些非肥胖者改变生活方式,如减轻体重或增加体力活动,可能会降低患2型糖尿病的风险。

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    2019-07-29 guojianrong
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    2019-07-09 一闲
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    2019-05-08 quxin068
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    2019-02-18 smartxiuxiu

    0

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    2019-02-16 misszhang

    谢谢MedSci提供最新的资讯

    0

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