Magda Shaheen1 *, Katrina M. Schrode1 , Marielle Tedlos 1 , Deyu Pan1 , Sonia M. Najjar 2 and Theodore C. Friedman1
1 Charles R. Drew University, Los Angeles, CA, United States, 2 Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States
Aim: Non-alcoholic fatty liver disease (NAFLD) exhibits a racial disparity. We examined the prevalence and the association between race, gender, and NAFLD among prediabetes and diabetes populations among adults in the United States.
Methods: We analyzed data for 3,190 individuals ≥18 years old from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. NAFLD was diagnosed by FibroScan ® using controlled attenuation parameter (CAP) values: S0 (none) < 238, S1 (mild) = 238-259, S2 (moderate) = 260-290, S3 (severe) > 290. Data were analyzed using Chi-square test and multinomial logistic regression, adjusting for confounding variables and considering the design and sample
Results: Of the 3,190 subjects, the prevalence of NAFLD was 82.6%, 56.4%, and 30.5% (p < 0.0001) among diabetes, prediabetes and normoglycemia populations respectively. Mexican American males with prediabetes or diabetes had the highest prevalence of severe NAFLD relative to other racial/ethnic groups (p < 0.05). In the adjusted model, among the total, prediabetes, and diabetes populations, a one unit increase in HbA1c was associated with higher odds of severe NAFLD [adjusted odds ratio (AOR) = 1.8, 95% confidence level (CI) = 1.4-2.3, p < 0.0001; AOR = 2.2, 95% CI = 1.1-4.4, p = 0.033; and AOR = 1.5, 95% CI = 1.1-1.9, p = 0.003 respectively].
Conclusion: We found that prediabetes and diabetes populations had a high prevalence and higher odds of NAFLD relative to the normoglycemic population and HbA1c is an independent predictor of NAFLD severity in prediabetes and diabetes populations. Healthcare providers should screen prediabetes and diabetes populations for early detection of NAFLD and initiate treatments including lifestyle modification to prevent the progression to non-alcoholic steatohepatitis or liver cancer.
KEYWORDS
NAFLD severity, prediabetes, diabetes, NHANES 2017-2018, race/ethnicity, gender
Jens Christian Laursen1*, Randi Jepsen2 , Neda Esmailzadeh Bruun-Rasmussen2 , Marie Frimodt-Møller1 , Marit Eika Jørgensen3 , Peter Rossing1,4 and Christian Stevns Hansen1
1 Complications Research, Steno Diabetes Center Copenhagen, Herlev, Denmark,
2Center for Epidemiological Research, Nykøbing Falster Hospital, Nykøbing Falster, Denmark,
3Steno Diabetes Center Greenland, Nuuk, Greenland, 4Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Aims: Low blood oxygen saturation is associated with increased mortality and persons with diabetes have sub-clinical hypoxemia. We aimed to confirm the presence of sub-clinical hypoxemia in pre-diabetes, screen-detected diabetes and known diabetes.
Methods: Pre-diabetes was defined as hemoglobin A1C (HbA1C) ≥ 42 mmol/mol and <48 mmol/mol; known diabetes as history or treatment of diabetes; screen-detected diabetes as no history or treatment of diabetes and HbA1C ≥ 48 mmol/mol. Blood oxygen saturation was measured with pulse oximetry. Urine albumin-to creatinine ratio (UACR) was measured on a single spot urine.
Results: The study included 829 adults (≥18 years) with diabetes (713 (86%) with known diabetes; 116 (14%) with screen-detected diabetes) and 12,747 without diabetes (11,981 (94%) healthy controls; 766 (6%) with pre-diabetes). Mean (95% CI) blood oxygen saturation was 96.3% (96.3% to 96.4%) in diabetes which was lower than in non-diabetes [97.3% (97.2–97.3%)] after adjustment for age, gender, and smoking (p < 0.001), but significance was lost after adjustment for BMI (p = 0.25). Sub-groups with pre-diabetes and screen-detected diabetes had lower blood oxygen saturations than healthy controls (p-values < 0.01). Lower blood oxygen saturation was associated with higher UACR.
Conclusions: Persons with pre-diabetes and screen-detected diabetes have sub-clinical hypoxemia, which is associated with albuminuria.
hypoxia, microvascular complications, albuminuria, type 2 diabetes, pre-diabetes
美国哈佛大学烧伤中心访问学者,全军烧伤专业委员会 常务委员,全国烧伤外科学分会青年委员会副主任委员,解放军医学杂志编委,中华烧伤杂志通讯编委。 擅长危重烧伤、颜面部烧伤、深度电烧伤和糖尿病足等难愈性创面治疗,特别是在疤痕与畸形整复方面经验丰富。
现任中华医学会创伤分会创面学组全国委员、中国医师学会烧伤分会全国委员、中华医学会烧伤分会青年委员、全军烧伤专业委员会委员、重庆市烧伤专业委员会委员、西南五省一巿烧伤整形学术委员会常委、中华烧伤杂志通讯编委、国家自然基金及SFDA新药评审专家、国外SCI杂志BURNS及Military Medicine等杂志审稿人等。
教授,烧伤科主任,博士生导师,国家级首批新世纪百千万人才工程人选、省烧伤外科专业委员会常委等。享受国务院特殊津贴。
管理治疗了大量烧烫伤、冻伤、电击伤、压疮及瘢痕患者,多次参与成批危重烧伤患者的救治工作。曾于国内外多所权威激光及整形治疗机构进修学习。
擅长: 各种烧伤治疗、表皮肿物去除和皮瓣成形、体表瘢痕防治,糖尿病足、褥疮、慢性难愈性创面的治疗;面部、胸部整形,自体脂肪移植。
从事整形、烧伤临床、教学、科研10年。2016年在中国科学院整形外科医院进修整1年,系统的学习了整形美容理论知识和临床手术技能。在国内第一作者发表论文6篇,参与发表论文20余篇,多篇为核心期刊。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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