不同非酒精性脂肪性肝病发病年龄与新发糖尿病的关联  

Correlation of nonalcoholic fatty liver disease at different ages of onset with new-onset diabetes mellitus

作　　者：杨慧[1] 陈朔华[2] 杨丽媛[1] 马立国[1] 曹立赢[3] 吴寿岭[2] Yang Hui;Chen Shuohua;Yang Liyuan;Ma Liguo;Cao Liying;Wu Shouling(Oncology Deparment of Kailuan General Hospital,Tangshan 063000,China;Internal Medicine-Cardiovascular Department of Kailuan General Hospital,Tangshan 063000.China;Hepatobiliary Surgery Department of Kailuan General Hospial,Tangshan 063000 China)

机构地区：[1]开滦总医院肿瘤科,唐山063000 [2]开滦总医院心内科,唐山063000 [3]开滦总医院肝胆科,唐山063000

出　　处：《中华肝脏病杂志》2022年第6期631-636,共6页Chinese Journal of Hepatology

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)不同发病年龄对新发糖尿病的影响。方法采用队列研究方法, 以开滦集团公司在职、离退休职工为研究对象, 排除基线已确诊的NAFLD、既往有糖尿病病史、长期大量饮酒史, 最终43 317例纳入队列。将研究对象按年龄分为5组(<30岁为1组, 30~39岁为2组, 40~49岁为3组, 50~59岁为4组, ≥60岁为5组), 比较各组NAFLD人群与非脂肪肝人群新发糖尿病发病率和发病密度, 采用多因素Cox回归模型分析NAFLD不同发病年龄对新发糖尿病的影响。采用单因素方差分析、χ^(2)检验或多因素Cox回归模型进行统计学分析。结果与非脂肪肝人群相比NAFLD人群的糖尿病发病率和发病密度均明显增高, 不同年龄分组糖尿病的发病率分别为6.45%、6.88%、9.94%、10.83%、11.43%, 各年龄组发病密度分别是9.21/千人年、11.10/千人年、16.17/千人年、18.72/千人年、22.13/千人年;差异有统计学意义(P<0.001)。多因素Cox回归模型结果显示, 在校正性别、收缩压、空腹血糖等混杂因素后, 各年龄组发生糖尿病的HR(95%CI)分别为3.992(1.897, 8.400)、2.321(1.589, 3.392)、2.041(1.667, 2.500)、2.007(1.708, 2.360)、1.908(1.570, 2.319);差异有统计学意义(P<0.001)。结论新发NAFLD是新发糖尿病的独立危险因素, NAFLD暴露得越早与同年龄相比糖尿病的发病风险越大。年龄越轻发生NAFLD更应重视和积极治疗。To investigate the effect of nonalcoholic fatty liver(NAFLD)at different ages of onset with new-onset diabetes mellitus.Methods The cohort study was conducted in Kailuan Group Company.Active and retired employees were used as study subjects.After excluding NAFLD diagnosed at baseline,previous history of diabetes mellitus,and long-term history of heavy drinking,43317 cases were finally included in the cohort.The study subjects were divided into five groups according to age(<30 years old as group 1,30-39 years old as group 2,40-49 years as group 3,50-59 years as group 4,and≥>60 years as group 5).The prevalence and incidence density of new-onset diabetes mellitus were compared between each NAFLD and non-fatty liver population group.The effect of NAFLD at different ages of onset with new-onset diabetes mellitus was analyzed by multivariate Cox's regression model.Statistical analysis was performed using one-way ANOVA,χ^(2) test or multivariate Cox's regression model.Results The prevalence and incidence density of diabetes mellitus was significantly higher in NAFLD than non-fatty liver population.The prevalence of diabetes mellitus in different age groups were 6.45%,6.88%,9.94%,10.83%,and 11.43%,respectively.The incidence density of each age group was 9.21/1000 person-years,11.10/1000 person-years,16.17/1000 person-years,18.72/1000 person-years,and 22.13/1000 person-years,and the differences were statistically significant(P<0.001).Multivariate Cox's regression model result showed that after adjusting for confounding factors such as gender,systolic blood pressure,and fasting blood glucose,the HRs(95%CI)for diabetes mellitus in each age group were 3.992(1.897,8.400),2.321(1.589,3.392),2.041(1.667,2.500),2.007(1.708,2.360),and 1.908(1.570,2.319),and the differences were statistically significant(P<0.001).Conclusion Newly developed NAFLD is an independent risk factor for new-onset diabetes mellitus.Early exposure to NAFLD increases the risk of developing diabetes mellitus compared with the same age group.Younger age of

关 键 词：非酒精性脂肪性肝病 发病年龄 糖尿病 研究队列 

分 类 号：R575[医药卫生—消化系统] R587.1[医药卫生—内科学]