糖尿病，血糖和脂肪肝，肝硬化和肝癌的发病率：50万人的前

StephenW

Hepatology. 2018 May 7. doi: 10.1002/hep.30083. [Epub ahead of print]
Diabetes, plasma glucose and incidence of fatty liver, cirrhosis and liver cancer: A prospective study of 0.5 million people.
Pang Y1, Kartsonaki C1,2, Turnbull I1, Guo Y3, Clarke R1, Chen Y1,2, Bragg F1, Yang L1,2, Bian Z3, Millwood IY1,2, Hao J4, Han X5, Zang Y6, Chen J7, Li L3,8, Holmes MV1,2,9, Chen Z1.
Author information

1
    Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
2
    Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
3
    Chinese Academy of Medical Sciences, 9 Dongdan San Tiao, Beijing, 100730, China.
4
    Qingdao Cancer Hospital, Qingdao, 266042, China.
5
    Yongqinglu Community Health Service Center, Qingdao, 266041, China.
6
    Qingdao Center for Disease Prevention and Control, Qingdao, 266033, China.
7
    School of Public Health, Peking University, Beijing 100191, China.
8
    National Center for Food Safety Risk Assessment, 37 Guangqu Road, Beijing, 100021, China.
9
    National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospital, Old Road, Oxford, OX3 7LE, UK.

Abstract

The prevalence of diabetes is increasing rapidly in China. However, evidence is limited about its effects on chronic liver diseases and liver cancer. We aimed to examine the associations of diabetes with chronic liver diseases and liver cancer and of random plasma glucose (RPG) with these liver diseases among participants without diabetes in Chinese adults, and to assess the possible interaction by hepatitis B virus (HBV) infection. The prospective China Kadoorie Biobank recruited 512,891 adults. During 10 years of follow-up, 2,568 liver cancer, 2,082 cirrhosis, 1,298 hospitalised non-alcoholic fatty liver disease (NAFLD), and 244 hospitalised alcoholic liver disease (ALD) were recorded among 503,993 participants without prior history of cancer or chronic liver diseases at baseline. Cox regression was used to estimate hazard ratios (HRs) for each disease by diabetes status (previously diagnosed or screen-detected) and, among those without previously diagnosed diabetes, by levels of RPG. Overall 5.8% of participants had diabetes at baseline. Compared with those without diabetes, individuals with diabetes had adjusted HRs of 1.49 (95% CI 1.30-1.70) for liver cancer, 1.81 (1.57-2.09) for cirrhosis, 1.76 (1.47-2.16) for NAFLD, and 2.24 (1.42-3.54) for ALD. The excess risks decreased but remained elevated in those with longer duration. Among those without previously diagnosed diabetes, RPG was positively associated with liver diseases, with adjusted HRs per 1 mmol/L higher RPG of 1.04 (1.03-1.06) for liver cancer, 1.07 (1.05-1.09) for cirrhosis, 1.07 (1.05-1.10) for NAFLD, and 1.10 (1.05-1.15) for ALD. These associations did not differ by HBV infection.
CONCLUSION:

In Chinese adults, diabetes and higher blood glucose levels among those without known diabetes are associated with increased risks of liver cancer and major chronic liver diseases. This article is protected by copyright. All rights reserved.

© 2018 by the American Association for the Study of Liver Diseases.
KEYWORDS:

Diabetes; cirrhosis; fatty liver disease; liver cancer; plasma glucose

PMID:
    29734463
DOI:
    10.1002/hep.30083

StephenW

肝病。 2018年5月7日，doi：10.1002 / hep.30083。 [电子版提前打印]
糖尿病，血糖和脂肪肝，肝硬化和肝癌的发病率：50万人的前瞻性研究。
Pang Y1，Kartsonaki C1,2，Turnbull I1，Guo Y3，Clarke R1，Chen Y1,2，Bragg F1，Yang L1,2，Bian Z3，Millwood IY1,2，Hao J4，Han X5，Zang Y6，Chen J7，李L3,8，福尔摩斯MV1,2,9，陈Z1。
作者信息

1
    临床试验服务单位和流行病学研究单位（CTSU），牛津大学纳菲尔德人口健康部，牛津，英国。
2
    医学研究委员会人口健康研究部（MRC PHRU），牛津大学纳菲尔德人口健康部，牛津，英国。
3
    中国医学科学院，北京市东单三桥9号，100730。
4
    青岛市肿瘤医院，青岛，266042
五
    永清路社区卫生服务中心，青岛，266041
6
    青岛市疾病预防控制中心，青岛，266033
7
    北京大学公共卫生学院，北京100191
8
    北京市广渠路37号国家食品安全风险评估中心，100021
9
    国家卫生研究院牛津大学医院牛津生物医学研究中心，牛津老路，OX3 7LE，英国。

抽象

中国糖尿病患病率迅速上升。然而，关于其对慢性肝病和肝癌的影响的证据是有限的。我们的目的是研究糖尿病与慢性肝病和肝癌以及随机血浆葡萄糖（RPG）与这些肝脏疾病在中国成人没有糖尿病的参与者之间的关系，并评估乙型肝炎病毒（HBV）感染可能的相互作用。未来的中国嘉道理生物银行招募了512,891名成人。在10年随访期间，503,993名参与者中没有记录2568例肝癌，2,082例肝硬化，1,298例住院非酒精性脂肪肝（NAFLD）和244例住院酒精性肝病（ALD），既往没有癌症或慢性肝病史在基线。 Cox回归用于评估每种疾病的糖尿病状态（先前诊断或筛查）以及未曾诊断为糖尿病的患者的RPG水平的风险比（HR）。总体5.8％的参与者在基线时患有糖尿病。与未患糖尿病的患者相比，糖尿病患者调整后的HR分别为1.49（95％CI 1.30-1.70），肝硬化1.81（1.57-2.09），NAFLD 1.76（1.47-2.16），和2.24（1.42-3.54 ）用于ALD。超额风险下降，但持续时间更长的风险仍然升高。在没有先前诊断为糖尿病的患者中，RPG与肝脏疾病呈正相关，每升高1毫摩尔/升RPG的肝癌调整HR为1.04（1.03-1.06），肝硬化为1.07（1.05-1.09），肝硬化为1.07（1.05-1.10） ）为NAFLD，ALD为1.10（1.05-1.15）。这些协会并没有因HBV感染而有所不同。
结论：

在中国成人中，没有已知糖尿病的人群中的糖尿病和更高的血糖水平与肝癌和主要慢性肝病的风险增加相关。本文受版权保护。版权所有。

©美国肝病研究协会版权所有©2018年。
关键词：

糖尿病;肝硬化;脂肪肝病;肝癌;血浆葡萄糖

结论：
    29734463
DOI：
    10.1002 / hep.30083