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

Steatohepatitis and Metabolic Liver Disease
Diabetes, plasma glucose and incidence of fatty liver, cirrhosis and liver cancer: A prospective study of 0.5 million people
Yuanjie Pang ScM
Christiana Kartsonaki DPhil
Iain Turnbull MRCP
Yu Guo ;MSc
Robert Clarke FRCP
Yiping Chen DPhil
Fiona Bragg DPhil
Ling Yang hD
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https://doi.org/10.1002/hep.30083


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.

StephenW

脂肪性肝炎和代谢性肝病
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
Yuanjie Pang ScM
克里斯蒂安娜Kartsonaki DPhil
Iain Turnbull MRCP
余国; MSc
罗伯特克拉克FRCP
陈一平DPhil
菲奥娜布拉格DPhil
凌洋;博士
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https://doi.org/10.1002/hep.30083


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，糖尿病和未知糖尿病患者的血糖水平升高与肝癌和主要慢性肝病的风险增加有关。本文受版权保护。版权所有。