金昌队列基线人群脂肪肝与2型糖尿病的关联性研究

摘要

Objective To explore the association between fatty liver and type 2 diabetes mellitus (T2DM) in the baseline-population of Jinchang cohort study.Methods Data from all the participants involved in the baseline-population of Jinchang cohort study was used,to compare the risks of T2DM in fatty liver and non fatty liver groups and to explore the interaction between family history or fatty liver of diabetes and the prevalence of T2DM.Results Among all the 46 861 participants,10 574 were diagnosed as having fatty liver (22.56％),with the standardized rate as 20.66％.Another 3 818 participants were diagnosed as having T2DM (8.15％) with standardized rate as 6.90％.The prevalence of T2DM increased in parallel with the increase of age (trendx2 =2 833.671,trend P＜ 0.001).The prevalence of T2DM in the fatty liver group was significantly higher than that in the non-fatty liver group,both in men or women and in the overall population.Compared with the group of non-fatty liver,the risks of T2DM in fatty liver group were seen 1.78 times higher in males,2.33 times in women and 2.10 times in the overall population,after adjustment for factors as age,levels of education,smoking,drinking,physical exercise,BMI,family history of diabetes and some metabolic indicators (pressure,TC,TG,uric acid,ALT,AST,gamma-glutamyl transferase).Date from the interaction model showed that fatty liver and family history of diabetes present a positive additive interaction on T2DM (RERI=1.18,95％CI:0.59-1.78;AP=0.24,95％CI:0.14-0.34;S=1.43,95％CI:1.21-1.69).Conclusions Fatty liver could significantly increase the risk of T2DM and a positive additive interaction was also observed between fatty liver and family history of diabetes on T2DM.It was important to strengthen the prevention program on T2DM,in order to effectively control the development of fatty liver.%目的 探讨金昌队列基线人群脂肪肝与2型糖尿病(T2DM)的关联,为T2DM的防治提供科学依据.方法 以金昌队列基线人群为研究对象,比较基线脂肪肝人群与非脂肪肝人群T2DM的患病风险,分析脂肪肝与糖尿病家族史对T2DM的患病是否存在交互作用.结果 在46 861名研究对象中,脂肪肝患者10 574例、患病率22.56％、标化患病率20.66％;T2DM患者3 818例、患病率为8.15％、标化患病率为6.90％.T2DM患病率随年龄增长呈趋势性升高(趋势x2=2 833.671,趋势P＜0.001);在男性、女性和总人群中,脂肪肝人群T2DM患病率均高于非脂肪肝人群,差异有统计学意义(P＜0.001).在调整了年龄、文化程度、吸烟、饮酒、体育锻炼、BMI、血压、TC、TG、尿酸、ALT、AST、谷氨酰转肽酶和糖尿病家族史后,在男性、女性和总人群中脂肪肝人群T2DM的患病风险是非脂肪肝人群的1.78、2.33和2.10倍.交互作用分析结果显示,脂肪肝与糖尿病家族史间存在正向相加交互作用.结论 脂肪肝能明显增加T2DM的患病风险;脂肪肝和糖尿病家族史对T2DM的发生有正向相加交互作用.有效控制脂肪肝的发生发展对T2DM的预防控制有着重要的作用.