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若年発症2型糖尿病患者におけるヘモグロビン値と非アルコール性脂肪肝疾患との関連性
Association between hemoglobin levels and non-alcoholic fatty liver disease in patients with young-onset type 2 diabetes mellitus.
PMID: 32684526 DOI: 10.1507/endocrj.EJ20-0071.
抄録
このレトロスペクティブ研究は、若年発症 2 型糖尿病（T2DM）患者におけるヘモグロビン（Hb）値と非アルコール性脂肪肝疾患（NAFLD）との関連を調査することを目的とした。2017年5月から2020年1月までに広西医科大学第一附属病院に入院した若年発症T2DM患者296人を対象にデータを収集した。被験者はNAFLD群（n=186）と非NAFLD群（n=110）に分けた。NAFLDの患者ではHb値が有意に高かった（p＝0.001）。ロジスティック回帰分析によると、交絡因子を調整した後、Hb値はNAFLDと有意に相関した［オッズ比（OR）＝1.024、95％信頼区間＝1.003～1.046、p＝0.028］。被験者はまた、Hb四分位に従ってグループ化された。性別と体格指数（BMI）を調整した後、NAFLDのOR（95％CI）はHb値の上昇とともに有意に増加した（pは傾向=0.009）。患者を除脂肪群（BMI＜25kg/m、n = 139）と過体重/肥満群（BMI≧25kg/m、n = 157）に分け、最高四分位の調整済みOR（95％CI）はそれぞれ1.797（0.559-5.776）と6.009（1.328-27.181）であった。さらにHbを性別に四分位に分類すると、男性では2.796（1.148-6.814）、女性では2.945（0.482-17.997）と、最も高い四分位と最も低い四分位の調整済みOR（95％CI）が示された。結論として、高Hb値は若年発症のT2DM患者、特に男性および過体重/肥満患者におけるNAFLDの存在と関連していた。
This retrospective study aimed to investigate the relationship between hemoglobin (Hb) levels and non-alcoholic fatty liver disease (NAFLD) in patients with young-onset type 2 diabetes mellitus (T2DM). Data were collected for 296 patients with young-onset T2DM admitted to the first Affiliated Hospital of Guangxi Medical University from May 2017 to January 2020. Subjects were divided into NAFLD (n = 186) and non-NAFLD groups (n = 110). Patients with NAFLD had significantly higher Hb levels (p = 0.001). According to logistic regression analysis, Hb levels were significantly correlated with NAFLD after adjusting for confounding factors [odds ratio (OR) = 1.024, 95% confidence interval = 1.003-1.046, p = 0.028]. Subjects were also grouped according to Hb quartiles. After adjusting for sex and body mass index (BMI), the OR (95%CI) for NAFLD significantly increased with increasing Hb levels (p for trend = 0.009). Patients were also divided into lean (BMI <25 kg/m, n = 139) and overweight/obese groups (BMI ≥25 kg/m, n = 157), with adjusted ORs (95%CI) for the highest quartiles of 1.797 (0.559-5.776) and 6.009 (1.328-27.181), respectively. Further quartile classification of Hb according to sex showed adjusted OR (95%CI) for the highest compared with the lowest quartile of 2.796 (1.148-6.814) for males and 2.945 (0.482-17.997) for females. In conclusion, high Hb levels were associated with the presence of NAFLD in patients with young-onset T2DM, especially in males and overweight/obese patients.