J Gastroenterol Hepatol:腰臀比是2型糖尿病患者肝脂肪变性和纤维化发生风险的独立预测指标

2017-11-29 MedSci MedSci原创

较高的WCR与不依赖胰岛素抵抗的NAFLD和肝纤维化的风险增加有关。这表明,WCR可能是一项有用的预测2型糖尿病患者肝脂肪变性发生风险的指标。

研究背景:尽管中心肥胖和骨骼肌减少与各种各样的心脏代谢紊乱有关,但是,它对2型糖尿病(T2D)中非酒精性脂肪性肝病的影响尚不清楚。本研究旨在研究腰臀比(WCR)是否能够预测2型糖尿病患者的非酒精性脂肪性肝病(NAFLD)和肝纤维化。

研究方法:本研究共纳入5507例2型糖尿病患者。使用腹部超声和预测评分判定肝脂肪变性。NAFLD被定义为无其他慢性肝病病因(病毒或酒精中毒)的肝脏脂肪变性。采用非侵入性血清生物标志物模型计算肝纤维化程度。短期胰岛素耐受性试验评估胰岛素耐受。

研究结果:NAFLD和肥胖(BMI>/=25g/m2 , 亚组定义)的流行率分别是46.4%和38.9%。通过胰岛素抵抗状态分层后,NAFLD的患病率随着WCR三分段的增加而增加,最低WCR分段,男性NAFLD患病率为36%,女性NAFLD患病率为28%;最高WCR分段,男性NAFLD患病率为53.8%,女性NAFLD患病率为58.2%,P值均小于0.001。WCR三分段的增加与NAFLD的发生独立相关,中间WCR分段和最高WCR分段,优势比分别是1.43和1.56。此外,NAFLD患者和最高WCR分段患者均有显著肝纤维化 (OR=8.62, 95%CI=1.39-53.36, P=0.021)。同时,WCR也与肌肉减少症有关(OR=3.18, 95%CI 2.50-4.05, p<0.001 highest)。

研究结论:较高的WCR与不依赖胰岛素抵抗的NAFLD和肝纤维化的风险增加有关。这表明,WCR可能是一项有用的预测2型糖尿病患者肝脂肪变性发生风险的指标。

原始出处


Choe EY, Lee YH, Choi YJ, et al. Waist-to-calf ratio is an independent predictor of hepatic steatosis and fibrosis patients with type 2 diabetes.J Gastroenterol Hepatol, 2017, Oct 8. doi: 10.1111/jgh.14011.

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createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jul 22 03:33:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1743241, encodeId=84db1e43241a1, content=<a href='/topic/show?id=74fc81413e3' target=_blank style='color:#2F92EE;'>#肝脂肪变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81413, encryptionId=74fc81413e3, topicName=肝脂肪变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=531535069436, createdName=10518105zz, createdTime=Tue Oct 23 16:33:00 CST 2018, time=2018-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711282, encodeId=1d131e1128275, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, 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CST 2017, time=2017-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474352, encodeId=859114e4352d3, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Fri Dec 01 12:33:00 CST 2017, time=2017-12-01, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1948764, encodeId=562d1948e6423, content=<a href='/topic/show?id=0602843360f' target=_blank style='color:#2F92EE;'>#脂肪变性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84336, encryptionId=0602843360f, topicName=脂肪变性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=346311, createdName=wgsun, createdTime=Mon Sep 17 12:33:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064257, encodeId=770a206425e5f, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jul 22 03:33:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1743241, encodeId=84db1e43241a1, content=<a href='/topic/show?id=74fc81413e3' target=_blank style='color:#2F92EE;'>#肝脂肪变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81413, encryptionId=74fc81413e3, topicName=肝脂肪变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=531535069436, createdName=10518105zz, createdTime=Tue Oct 23 16:33:00 CST 2018, time=2018-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711282, encodeId=1d131e1128275, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, 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encodeId=c23b1426924ce, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Fri Dec 01 12:33:00 CST 2017, time=2017-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463577, encodeId=9faa14635e74e, content=<a href='/topic/show?id=7d27381288e' target=_blank style='color:#2F92EE;'>#变性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38128, encryptionId=7d27381288e, topicName=变性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f69f6545041, createdName=huangdf, createdTime=Fri Dec 01 12:33:00 CST 2017, time=2017-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474352, encodeId=859114e4352d3, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Fri Dec 01 12:33:00 CST 2017, time=2017-12-01, status=1, ipAttribution=)]
    2018-10-27 许安
  6. [GetPortalCommentsPageByObjectIdResponse(id=1948764, encodeId=562d1948e6423, content=<a href='/topic/show?id=0602843360f' target=_blank style='color:#2F92EE;'>#脂肪变性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84336, encryptionId=0602843360f, topicName=脂肪变性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=346311, createdName=wgsun, createdTime=Mon Sep 17 12:33:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064257, encodeId=770a206425e5f, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, 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  7. 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  8. 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    2017-12-01 gwc384
  9. 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    2017-12-01 huangdf
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