[Predictive factors for MASLD in type 2 diabetes: 1 year follow-up study].

Niels H Wacher, Rita A Gómez-Díaz, Adriana L Valdez-González, Ximena Duque-López, Segundo Morán-Villota, Rafael Mondragón-González, Miguel Cruz-López, Víctor H Borja-Aburto
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Abstract

Background: It has been proposed the current nomenclature for metabolic dysfunction-associated steatotic liver disease (MASLD) as a general term to encompass the various etiologies of steatosis and to include the presence of at least 1 of 5 cardiometabolic risk factors.

Objective: To evaluate the predictors of the incidence of MASLD in patients with type 2 diabetes (T2D) in primary care at a one-year follow-up.

Material and methods: Prospective cohort study including patients (n = 5143) with ≤ 15 years from diagnosis of T2D, treated at primary care units in Mexico City and metropolitan area. At baseline and at one-year follow-up were measured: anthropometry, HbA1c, microalbuminuria, creatinine, lipid profile and hepatic markers aspartate aminotransferase and alanine aminotransferase (ALT). Hepatic Steatosis Index (HSI) and Lipidic Accumulation Product (LAP) were calculated. MASLD was considered as cases with abnormal ALT.

Results: At baseline, 1449 (28.2%) patients presented MASLD. The HSI and LAP indices were higher in MASLD. Age at diagnosis and time of exposure to T2D were inversely associated with MASLD, and directly proportional to body mass index, waist circumference (WC) and HbA1c. Of the cases with MASLD at baseline, 452 (38.8%) reverted to normal and 712 (61.2%) persisted after follow-up. ORs for MASLD were 1.86 and 1.88 for HbA1c and WC, respectively.

Conclusions: The combination of HSI, LAP and screening with HbA1c and WC are useful to identify MASLD in patients with T2D.

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[2 型糖尿病 MASLD 的预测因素:1 年随访研究]。
背景:有人提出了代谢功能障碍相关性脂肪性肝病(MASLD)这一通用术语,以涵盖脂肪变性的各种病因,并包括5种心脏代谢风险因素中至少一种因素的存在:评估基层医疗机构中2型糖尿病(T2D)患者一年随访期间MASLD发病率的预测因素:前瞻性队列研究包括墨西哥城和大都会地区初级医疗单位治疗的确诊 T2D 不超过 15 年的患者(n = 5143)。基线和一年随访期间的测量指标包括:人体测量、HbA1c、微量白蛋白尿、肌酐、血脂、肝脏指标天冬氨酸氨基转移酶和丙氨酸氨基转移酶(ALT)。计算肝脏脂肪变性指数(HSI)和脂质累积产物(LAP)。ALT 异常的病例被视为 MASLD:基线时,1449 例(28.2%)患者出现 MASLD。MASLD患者的HSI和LAP指数较高。确诊年龄和患 T2D 的时间与 MASLD 呈反比,与体重指数、腰围 (WC) 和 HbA1c 成正比。在基线时患有MASLD的病例中,452例(38.8%)在随访后恢复正常,712例(61.2%)持续存在。HbA1c 和 WC 的 MASLD OR 分别为 1.86 和 1.88:结论:HSI、LAP 和 HbA1c 及 WC 筛查相结合,有助于识别 T2D 患者的 MASLD。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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