中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
Chinese Journal of Hepatology
2015年
10期
754-759
,共6页
王珊%张海玲%佟博%王谦%张艳敏%朱国玲%吴寿岭
王珊%張海玲%佟博%王謙%張豔敏%硃國玲%吳壽嶺
왕산%장해령%동박%왕겸%장염민%주국령%오수령
脂肪肝,非酒精性%体质量指数%2型糖尿病%队列研究
脂肪肝,非酒精性%體質量指數%2型糖尿病%隊列研究
지방간,비주정성%체질량지수%2형당뇨병%대렬연구
Fatty liver,non-alcoholic%Body mass index%Type 2 diabetes mellitus%Cohort study
目的 探讨体质量指数(BMI)对2型糖尿病患者新发非酒精性脂肪肝(NAFLD)的影响.方法 此研究为前瞻性队列研究,以参加2006-2007年度健康体检者101 510人中符合2型糖尿病诊断标准且未合并NAFLD的人群作为观察队列,纳入最终统计分析的有效数据为2 847例,根据基线BMI分为低体质量组、正常体质量组、超重组和肥胖组,随访各组2008-2009、2010-2011、2012-2013年度体检时NAFLD的发病情况,比较各组NAFLD的累积发病率,用Cox比例风险回归模型分析基线BMI对2型糖尿病患者新发NAFLD的影响. 结果 (1) NAFLD的累积发病率随着基线BMI的增加而增加(分别为69％、73％、90％、97％),差异有统计学意义(P＜0.01).(2)超重组、肥胖组NAFLD发病风险分别为正常体质量组的2.00 (1.76 ～ 2.29)、2.87 (2.42 ～ 3.40)倍(P＜ 0.01);用Cox比例风险回归模型校正年龄、性别等多种混杂因素后,超重组及肥胖组NAFLD发病风险仍为正常体质量组的1.73 (1.49 ～ 2.00)、2.12 (1.73 ～ 2.60)倍(P＜0.01).结论 2型糖尿病患者发生NAFLD的风险随着BMI的增加而增加,BMI增加是NAFLD发病的独立危险因素.
目的 探討體質量指數(BMI)對2型糖尿病患者新髮非酒精性脂肪肝(NAFLD)的影響.方法 此研究為前瞻性隊列研究,以參加2006-2007年度健康體檢者101 510人中符閤2型糖尿病診斷標準且未閤併NAFLD的人群作為觀察隊列,納入最終統計分析的有效數據為2 847例,根據基線BMI分為低體質量組、正常體質量組、超重組和肥胖組,隨訪各組2008-2009、2010-2011、2012-2013年度體檢時NAFLD的髮病情況,比較各組NAFLD的纍積髮病率,用Cox比例風險迴歸模型分析基線BMI對2型糖尿病患者新髮NAFLD的影響. 結果 (1) NAFLD的纍積髮病率隨著基線BMI的增加而增加(分彆為69％、73％、90％、97％),差異有統計學意義(P＜0.01).(2)超重組、肥胖組NAFLD髮病風險分彆為正常體質量組的2.00 (1.76 ～ 2.29)、2.87 (2.42 ～ 3.40)倍(P＜ 0.01);用Cox比例風險迴歸模型校正年齡、性彆等多種混雜因素後,超重組及肥胖組NAFLD髮病風險仍為正常體質量組的1.73 (1.49 ～ 2.00)、2.12 (1.73 ～ 2.60)倍(P＜0.01).結論 2型糖尿病患者髮生NAFLD的風險隨著BMI的增加而增加,BMI增加是NAFLD髮病的獨立危險因素.
목적 탐토체질량지수(BMI)대2형당뇨병환자신발비주정성지방간(NAFLD)적영향.방법 차연구위전첨성대렬연구,이삼가2006-2007년도건강체검자101 510인중부합2형당뇨병진단표준차미합병NAFLD적인군작위관찰대렬,납입최종통계분석적유효수거위2 847례,근거기선BMI분위저체질량조、정상체질량조、초중조화비반조,수방각조2008-2009、2010-2011、2012-2013년도체검시NAFLD적발병정황,비교각조NAFLD적루적발병솔,용Cox비례풍험회귀모형분석기선BMI대2형당뇨병환자신발NAFLD적영향. 결과 (1) NAFLD적루적발병솔수착기선BMI적증가이증가(분별위69％、73％、90％、97％),차이유통계학의의(P＜0.01).(2)초중조、비반조NAFLD발병풍험분별위정상체질량조적2.00 (1.76 ～ 2.29)、2.87 (2.42 ～ 3.40)배(P＜ 0.01);용Cox비례풍험회귀모형교정년령、성별등다충혼잡인소후,초중조급비반조NAFLD발병풍험잉위정상체질량조적1.73 (1.49 ～ 2.00)、2.12 (1.73 ～ 2.60)배(P＜0.01).결론 2형당뇨병환자발생NAFLD적풍험수착BMI적증가이증가,BMI증가시NAFLD발병적독립위험인소.
Objective To investigate the effect of body mass index (BMI) on new-onset non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM).Methods Subjects with T2DM were recruited from the population of individuals attending the Affiliated General Hospital of North China University for routine health examination between 2006 and 2007 and offered participation in this communitybased prospective cohort study.Enrollees were categorized into groups according to weight assessed by baseline BMI (underweight, normal, overweight, and obese groups).Cumulative incidence of NAFLD was compared between each group and the effect of baseline BMI on new-onset NAFLD was assessed by Cox regression analysis.Results The cumulative incidence of NAFLD increased in conjunction with increases in weight (low weight: 69％, normal weight: 73％, overweight: 90％, obese: 97％;P ＜ 0.01).Subjects in the overweight and obese groups showed an increased risk of NAFLD (relative risk (RR) =2.00, 95％ CI: 1.76-2.29 and =2.87, 95％ CI: 2.42-3.40;P ＜ 0.01), compared to those in the normal weight group.Moreover, after adjustment for baseline factors (e.g.age, sex) risk of NAFLD remained higher for the overweight and obese subjects (RR =1.73, 95％ CI: 1.49-2.00 and =2.12, 95％ CI: 1.73-2.60;P ＜ 0.01).Conclusion Risk of NAFLD in T2DM patients increases in parallel to increase in weight assessed by BMI.BMI appeared to be an independent risk factor for NAFLD.
