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논문 기본 정보

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학술저널
저자정보
Cheng Han Ng (Yong Loo Lin School of Medicine National University of Singapore) Kai En Chan (Yong Loo Lin School of Medicine National University of Singapore) Yip Han Chin (Yong Loo Lin School of Medicine National University of Singapore) Rebecca Wenling Zeng (Yong Loo Lin School of Medicine National University of Singapore) Pei Chen Tsai (Yong Loo Lin School of Medicine National University of Singapore) Wen Hui Lim (Yong Loo Lin School of Medicine National University of Singapore) Darren Jun Hao Tan (Yong Loo Lin School of Medicine National University of Singapore) Chin Meng Khoo (Division of Endocrinology Department of Medicine National University Hospital) Lay Hoon Goh (Division of Family Medicine Yong Loo Lin School of Medicine National University of Singapore) Zheng Jye Ling (Department of Family Medicine National University Health System) Anand Kulkarni (Department of Hepatology AIG Hospitals) Lung-Yi Loey Mak (Department of Medicine The University of Hong Kong Queen Mary Hospital) Daniel Q Huang (Yong Loo Lin School of Medicine National University of Singapore) Mark Chan (Department of Cardiology National University Heart Centre National University Hospital) Nicholas WS Chew (Yong Loo Lin School of Medicine National University of Singapore) Mohammad Shadab Siddiqui (Department of Medicine Comprehensive Transplant Centre Cedars-Sinai Medical Centre) Arun J Sanyal (Department of Internal Medicine Virginia Commonwealth University) Mark Muthiah (Yong Loo Lin School of Medicine National University of Singapore)
저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제28권 제3호
발행연도
2022.7
수록면
565 - 574 (10page)
DOI
10.3350/cmh.2022.0096

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Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is closely associated with diabetes. The cumulative impact of both diseases synergistically increases risk of adverse events. However, present population analysis is predominantly conducted with reference to non-NAFLD individuals and has not yet examined the impact of prediabetes. Hence, we sought to conduct a retrospective analysis on the impact of diabetic status in NAFLD patients, referencing non-diabetic NAFLD individuals. Methods: Data from the National Health and Nutrition Examination Survey 1999?2018 was used. Hepatic steatosis was defined with United States Fatty Liver Index (US-FLI) and FLI at a cut-off of 30 and 60 respectively, in absence of substantial alcohol use. A multivariate generalized linear model was used for risk ratios of binary outcomes while survival analysis was conducted with Cox regression and Fine Gray model for competing risk. Results: Of 32,234 patients, 28.92% were identified to have NAFLD. 36.04%, 38.32% and 25.63% were non-diabetic, prediabetic and diabetic respectively. Diabetic NAFLD significantly increased risk of cardiovascular disease (CVD), stroke, chronic kidney disease, all-cause and CVD mortality compared to non-diabetic NAFLD. However, prediabetic NAFLD only significantly increased the risk of CVD and did not result in a higher risk of mortality. Conclusions: Given the increased risk of adverse outcomes, this study highlights the importance of regular diabetes screening in NAFLD and adoption of prompt lifestyle modifications to reduce disease progression. Facing high cardiovascular burden, prediabetic and diabetic NAFLD individuals can benefit from early cardiovascular referrals to reduce risk of CVD events and mortality.
#Diabetes mellitus #Non-alcoholic fatty liver Disease #Prediabetic state

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