2型糖尿病和MASLD/相关SLD状态变化与发生心血管疾病风险的关系

IF 5.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Yasuhiro Matsubayashi, Kazuya Fujihara, Laymon Khin, Efrem d'Àvila Ferreira, Shizuka Takabayashi, Yuko Yamashita, Takaho Yamada, Satoru Kodama, Hirohito Sone
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引用次数: 0

摘要

背景与目的该研究评估了2型糖尿病(DM)缓解或代谢功能障碍相关性脂肪肝(MASLD)/相关性脂肪肝(r-SLD;MASLD伴酒精摄入过多)(以脂肪肝指数定义)与心血管疾病(CVD)风险的关系。方法:从日本全国性索赔数据库中提取基线和2年(2-Years)后的健康检查数据。在年龄为 18-72 岁、随访至少 3 年的参与者中,有 9345 人基线时患有与 DM 相关的 MASLD/r-SLD,71932 人基线时患有非 DM MASLD/r-SLD。研究人员根据 MASLD/r-SLD 或 DM 在 2 年后是否得到缓解对参与者进行了分层。在分层后的各组中,使用多变量考克斯比例危险模型分析了观察期内新发心血管疾病的风险:结果:在中位 4.9 年的随访期间(从 2 岁开始),共观察到 1368 例心血管疾病。糖尿病缓解者的心血管疾病危险比(95% 置信区间)为 0.50(0.31-0.80),MASLD/r-SLD 缓解者的心血管疾病危险比为 0.65(0.47-0.91),糖尿病和 MASLD/r-SLD 均缓解者的心血管疾病危险比为 0.34(0.15-0.77)。相反,MASLD/r-SLD缓解与非DM MASLD/r-SLD患者心血管疾病风险降低无关:结论:MASLD/r-SLD缓解与心血管疾病风险的关系在有无糖尿病之间存在很大差异。在患有 DM-MASLD/r-SLD 的患者中,MASLD/r-SLD 的缓解与 DM 的缓解一样,可以显著降低心血管疾病风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of changes in the type 2 diabetes and MASLD/related SLD status with risk of developing cardiovascular disease.

Background & aims: This study assessed the association of remission of type 2 diabetes mellitus (DM) or metabolic dysfunction-associated steatotic liver disease (MASLD)/related SLD (r-SLD; MASLD with excessive alcohol intake) as defined by the fatty liver index with the risk of cardiovascular disease (CVD).

Methods: Health examination data at baseline and after 2 years (2-Years) were extracted from a nationwide claims database in Japan. Among participants aged 18-72 years with at least 3 years of follow-up, 9345 participants with DM-associated MASLD/r-SLD and 71 932 participants with non-DM MASLD/r-SLD at baseline were included in the study. The participants were stratified by the achievement of remission of MASLD/r-SLD or DM at 2-Years. In each group after stratification, the risk of new-onset CVD during the observation period was analysed using multivariate Cox proportional hazards models.

Results: During a median follow-up of 4.9 years (starting from 2-Years), 1368 cases of CVD were observed. The hazard ratio (95% confidence interval) for CVD was 0.50 (0.31-0.80) for participants with remission of DM, 0.65 (0.47-0.91) for participants with remission of MASLD/r-SLD, and 0.34 (0.15-0.77) for participants with remission of both DM and MASLD/r-SLD. Conversely, remission of MASLD/r-SLD was not linked to a reduced risk of CVD in participants with non-DM MASLD/r-SLD.

Conclusion: The association of MASLD/r-SLD remission with CVD risk differs greatly in the presence and absence of DM. In patients with DM-MASLD/r-SLD, MASLD/r-SLD remission can significantly reduce CVD risk similarly as remission of DM.

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来源期刊
Diabetes, Obesity & Metabolism
Diabetes, Obesity & Metabolism 医学-内分泌学与代谢
CiteScore
10.90
自引率
6.90%
发文量
319
审稿时长
3-8 weeks
期刊介绍: Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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