Τετάρτη 21 Οκτωβρίου 2020

Adolescent Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Young Adulthood.

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Adolescent Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Young Adulthood.

J Clin Endocrinol Metab. 2020 Oct 19;:

Authors: Bardugo A, Bendor CD, Zucker I, Lutski M, Cukierman-Yaffe T, Derazne E, Mosenzon O, Tzur D, Beer Z, Pinhas-Hamiel O, Ben-Ami M, Fishman B, Ben-Ami Shor D, Raz I, Afek A, Gerstein HC, Häring HU, Tirosh A, Levi Z, Twig G

Abstract
CONTEXT: The long-term risk of type 2 diabetes in adolescents with nonalcoholic fatty liver disease (NAFLD) is unclear.
OBJECTIVE: To assess type 2 diabetes risk among adolescents with NAFLD.
DESIGN AND SETTING: A nationwide, population-based study of Israeli adolescents who were examined before military service during 1997-2011 and were followed until December 31, 2016.
PARTICIPANTS: A total of 1,025,796 normoglycemic adolescents were included.
INTERVENTIONS: Biopsy or radiographic tests were prerequisite for NAFLD diagnosis. Data were linked to the Israeli National Diabetes Registry.
MAIN OUTCOME MEASURES: Type 2 diabetes incidence.
RESULTS: During a mean follow-up of 13.3 years, 12 of 633 adolescents with NAFLD (1.9%; all with high BMI at baseline) were diagnosed with type 2 diabetes as compared to 2,917 (0.3%) adolescents without NAFLD. The hazard ratio (HR) for type 2 diabetes was 2.59 (95% CI 1.47-4.58) for the NAFLD vs. the non-NAFLD group after adjustment for BMI and socio-demographic confounders. The elevated risk persisted in several sensitivity analyses. These included an analysis of persons without other metabolic comorbidities (adjusted HR 2.75 [95% CI 1.48-5.14]) and of persons with high BMI; and an analysis whose outcome was type 2 diabetes by age 30 years (adjusted HR 2.14 [95% CI 1.02-4.52]). The results remained significant when a sex-, birth year- and BMI-matched control group was the reference (adjusted HR 2.98 [95% CI 1.54-5.74]).
CONCLUSIONS: Among normoglycemic adolescents, NAFLD was associated with an increased adjusted risk for type 2 diabetes, which may be apparent before age 30 years.

PMID: 33075820 [PubMed - as supplied by publisher]

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