Trends in risk factor control and treatment among patients with non‐alcoholic fatty liver disease and type 2 diabetes between 2000 and 2020: A territory‐wide study

医学 2型糖尿病 脂肪肝 内科学 糖尿病 二甲双胍 置信区间 风险因素 胃肠病学 血压 疾病 内分泌学 胰岛素
作者
Xinrong Zhang,Terry Cheuk‐Fung Yip,Yee–Kit Tse,Vicki Wing‐Ki Hui,Guanlin Li,Huapeng Lin,Lilian Yan Liang,Jimmy Shiu Ming Lai,Mandy Sze-Man Lai,Johnny T. K. Cheung,Henry Lik‐Yuen Chan,Stephen L. Chan,Alice Pik‐Shan Kong,Grace Lai‐Hung Wong,Vincent Wai‐Sun Wong
出处
期刊:Alimentary Pharmacology & Therapeutics [Wiley]
卷期号:57 (10): 1103-1116 被引量:2
标识
DOI:10.1111/apt.17428
摘要

Summary Background & Aims We aimed to determine the trends in risk factor control and treatment among patients with non‐alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D) in 2000–2020. Methods We conducted a territory‐wide cohort study of adult patients with NAFLD and T2D diagnosed between 1 January 2000 and 31 July 2021 in Hong Kong. T2D was defined by use of any anti‐diabetic agents, laboratory tests and/or diagnosis codes. Results This study included 16,084 patients with NAFLD and T2D (mean age, 54.8 ± 12.0 years; 7124 male [44.3%]). The percentage of patients achieving individualised haemoglobin A 1c (HbA 1c ) targets increased from 44.5% (95% confidence interval [CI], 42.9–46.1) to 64.8% (95% CI, 64.1–65.5), and percentage of patients achieving individualised low‐density lipoprotein‐cholesterol (LDL‐C) targets increased from 23.3% (95% CI, 21.9–24.7) to 54.3% (95% CI, 53.5–55.1) from 2000–2005 to 2016–2020, whereas percentage of patients achieving blood pressure control (<140/90 mm Hg) remained static at 53.1–57.2%. Combination therapy for diabetes increased, especially among those with poor glycaemic control, but there was no increase in combination therapy for hypertension. Fewer cirrhotic patients achieved blood pressure control and individualised LDL‐C targets, but they were more likely to achieve individualised HbA 1c targets than non‐cirrhotics. Metformin and statins were underused in cirrhotic patients. Younger patients (18–44 years) were less likely to achieve individualised HbA 1c targets than middle‐aged (45–64 years) and older ones (≥65 years). Conclusions From 2000 to 2020, glycaemic and lipid control improved significantly, whereas blood pressure control remained static among patients with NAFLD and T2D.
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