Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease.

IF 6.8 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolism Journal Pub Date : 2024-05-01 Epub Date: 2024-02-02 DOI:10.4093/dmj.2023.0200

Teruki Miyake, Shinya Furukawa, Bunzo Matsuura, Osamu Yoshida, Masumi Miyazaki, Akihito Shiomi, Ayumi Kanamoto, Hironobu Nakaguchi, Yoshiko Nakamura, Yusuke Imai, Mitsuhito Koizumi, Takao Watanabe, Yasunori Yamamoto, Yohei Koizumi, Yoshio Tokumoto, Masashi Hirooka, Teru Kumagi, Eiji Takesita, Yoshio Ikeda, Masanori Abe, Yoichi Hiasa

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引用次数: 0

Abstract

Backgruound: Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.

Methods: This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%-6.4%, 6.5%-7.4%, and ≥7.5%.

Results: Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%-6.4%, 6.5%-7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%- 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.

Conclusion: Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%-7.4%, contributing to NAFLD progression.

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血糖控制与非酒精性脂肪肝的组织学发现有关。

背景：不良的生活习惯可能会加重非酒精性脂肪肝（NAFLD），并发展为非酒精性脂肪性肝炎（NASH）和肝硬化。本研究调查了血糖控制状况与肝组织学结果之间的关联，以阐明血糖控制对非酒精性脂肪肝的影响：这项观察性研究纳入了 331 名通过肝活检确诊为非酒精性脂肪肝的患者。通过比较非酒精性脂肪肝诊断时的糖化血红蛋白（HbA1c）水平确定的以下四个血糖状态组：≤5.4%、5.5%-6.4%、6.5%-7.4%和≥7.5%，评估血糖控制状态对非酒精性脂肪肝组织学结果的影响：与最低 HbA1c 组（≤5.4%）相比，较高 HbA1c 组（5.5%-6.4%、6.5%-7.4% 和≥7.5%）与晚期肝纤维化和高 NAFLD 活性评分（NAS）相关。经多变量分析，在调整年龄、性别、血红蛋白、丙氨酸氨基转移酶和肌酐水平后，与最低 HbA1c 组相比，HbA1c 水平在 6.5%-7.4% 组与肝纤维化晚期显著相关。如果进一步控制体重指数和尿酸、总胆固醇和甘油三酯水平，与 HbA1c 最低组相比，HbA1c 较高组与晚期纤维化显著相关。另一方面，在两项多变量分析中，与 HbA1c 最低组相比，HbA1c 较高组也与高 NAS 相关：结论：血糖控制与非酒精性脂肪肝恶化有关，即使血糖控制轻度恶化，尤其是 HbA1c 水平在 6.5%-7.4% 之间，也会导致非酒精性脂肪肝恶化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

10.40

自引率

6.80%

发文量

审稿时长

52 weeks

期刊介绍： The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.