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与酒精相关的肝病中的糖尿病:流行率和结果
Ben Ward1, Mark Theodoreson1,2, Guruprasad Aithal3
1Leeds Liver Unit, St James's University Hospital, Leeds, UK.
糖尿病 (DM) 在酒精相关肝病 (ALD) 患者中显著增加与肝脏相关的死亡率. 管理糖尿病对于改善ALD患者的治疗结果至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 酒精相关性肝病 (ALD) 是一个主要的全球健康问题,导致严重的发病率和死亡率.
- 已知糖尿病 (DM) 会使其他形式的脂肪肝疾病的结果恶化.
研究的目的:
- 为了研究糖尿病与活检证明的酒精相关肝病患者的不良结果之间的关系.
- 评估糖尿病对ALD患者肝脏相关死亡率和临床事件的影响.
主要方法:
- 国际多中心全球酒精相关肝病结果 (WALDO) 队列的回顾性分析.
- 包括活检证明的ALD患者,注意到DM的存在和发展.
- 使用DM的Cox比例危险模型作为时间依赖变量来分析死亡和肝脏相关临床事件 (LACE) 的风险.
主要成果:
- 该研究包括712名患者,平均随访时间为4.8年.
- 在基线时,DM存在于15.9%的患者中,在随访期间还有7.8%的患者发展为DM.
- 在多变量分析中,糖尿病与肝脏相关死亡率 (HR: 1.79) 和事件LACE (HR: 1.90) 的增加显著相关.
结论:
- 糖尿病是ALD患者常见的并发症.
- 在ALD患者中,DM独立地与与肝脏相关死亡的风险大大增加有关.
- 临床医生在治疗ALD患者时应将糖尿病状况视为关键因素.
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