医学
糖尿病
内科学
脂肪肝
危险系数
前瞻性队列研究
亚临床感染
动脉硬化
脉冲波速
内膜中层厚度
2型糖尿病
疾病
胃肠病学
心脏病学
内分泌学
置信区间
血压
颈动脉
作者
Bin Wang,Zhiyun Zhao,Shanshan Liu,Shuangyuan Wang,Yuhong Chen,Yu Xu,Min Xu,Weiqing Wang,Guang Ning,Mian Li,Tiange Wang,Yufang Bi
标识
DOI:10.1016/j.diabres.2021.108873
摘要
Aims To investigate the impact of diabetes on subclinical atherosclerosis and cardiovascular disease (CVD) in individuals with and without non-alcoholic fatty liver disease (NAFLD). Methods The prospective cohort study included 8451 Chinese adults free of baseline CVD in 2010. NAFLD was diagnosed based on hepatic ultrasonography. Fibrosis-4 index as a non-invasive marker was used to evaluate the degree of fibrosis. Subclinical atherosclerosis was evaluated by carotid intima-media thickness, brachial-ankle pulse wave velocity, ankle-brachial index, and carotid plaque. At follow-up during 2014–2016, the composite of incident fatal or nonfatal CVD were ascertained. Results Of the 8451 participants, 2557 (30.3%) had NAFLD at baseline. Diabetes was associated with arterial stiffness and carotid plaque in participants with NAFLD (P < 0.001). Similar associations were observed in participants without NAFLD. During a mean 4.6 years of follow-up, 432 incident CVD events occurred. The multivariable-adjusted hazard ratio (HR) for CVD events associated with diabetes was 1.27 (95% CI 0.90–1.81) in participants with NAFLD and 1.73 (95% CI 1.32–2.26) in those without NAFLD (P for interaction = 0.21). Among participants with NAFLD who had pre-existing diabetes, those with ≥5 years of diabetes duration had an adjusted HR of 2.02 (95% CI 1.12–3.62) for CVD as compared to those with <2 years of duration. When categorizing participants with NAFLD by fibrosis severity, diabetes conferred an increased risk of CVD in those with potential advanced fibrosis. Conclusions Among participants with NAFLD, diabetes was associated with prevalent atherosclerosis, and a long duration of diabetes was associated with an increased risk of developing CVD. The effects of diabetes on cardiovascular outcomes did not appreciably differ by NAFLD status.
科研通智能强力驱动
Strongly Powered by AbleSci AI