糖尿病代谢功能障碍相关的脂肪肝疾病的死亡结果:非肥胖与肥胖个体之间的比较
Pengwei Zhang1, Yijun Zeng2, Sijia Yang2
1Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, 310015, China.
患有2型糖尿病 (T2DM) 和代谢功能障碍相关脂肪肝 (MAFLD) 的患者,无论体重如何,都面临更高的死亡风险. 在T2DM患者中早期查MAFLD对于更好的生存结果至关重要.
科学领域:
- 肝病学和胃肠病学 肝病学和胃肠学
- 代谢障碍 代谢障碍 代谢障碍
- 流行病学 流行病学
背景情况:
- 与代谢功能障碍相关的脂肪肝疾病 (MAFLD) 是一个日益严重的全球健康问题.
- 同时患有2型糖尿病 (T2DM) 和肥胖对MAFLD患者存活率的影响仍然不完全理解.
- 了解MAFLD亚型之间的生存差异对于风险分层和管理至关重要.
研究的目的:
- 为了比较四个不同的MAFLD患者群体的长期存活率:糖尿病患者超重/肥胖 (OT2M),糖尿病患者瘦/正常体重 (LT2M),非糖尿病患者超重/肥胖 (OM) 和非糖尿病患者瘦/正常体重 (LM).
- 评估MAFLD亚型与全因,心血管疾病 (CVD) 相关和癌症相关死亡率之间的关联.
- 为了确定肥胖状况是否会改变糖尿病MAFLD患者的死亡风险.
主要方法:
- 使用了国家健康和营养检查调查III (NHANESIII) 数据库来获取参与者数据.
- 将MAFLD患者根据T2DM状态和BMI (超重/肥胖与瘦/正常体重) 分类为四组.
- 采用Cox的比例危险模型来计算死亡率结果的危险比率 (HR) 和95%置信区间 (CI),并对相关的共变量进行调整.
主要成果:
- 总共有3539名参与者被分析,其中1618人 (42.61%) 在平均274.41个月的随访期间死亡.
- 瘦肉型T2DM与MAFLD (LT2M) 和超重/肥胖型T2DM与MAFLD (OT2M) 两组都表现出与超重/肥胖 (OM) 的非糖尿病型MAFLD相比,所有原因的死亡风险显著更高.
- 与OM组相比,LT2M和OT2M组也显示了与心血管疾病相关的死亡风险大幅增加,突出了T2DM在MAFLD患者的有害影响,无论体重如何.
结论:
- 同时T2DM显著提高MAFLD患者的死亡风险,无论肥胖状况如何.
- 患有糖尿病MAFLD (LT2M) 的瘦个体面临的死亡风险与他们的超重/肥胖同行 (OT2M) 相同,甚至更高.
- 建议对所有T2DM患者进行MAFLD查,强调无论体重如何,都需要积极管理.
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