Article Text
Abstract
Introduction Non-alcoholic fatty liver disease (NAFLD) is a global health problem with high geographic heterogeneity. We aimed to investigate regional-specific concomitant rate of NAFLD and quantitative relationship between liver fat content (LFC) and glucose metabolism parameters in representative clinical populations from six provinces/municipalities of China.
Research design and methods A total of 2420 eligible Han Chinese were enrolled consecutively from 10 clinics of obesity, diabetes and metabolic diseases located at six provinces/municipalities of China, and divided into North (Tianjin, Shandong and Heilongjiang) and South (Shanghai, Jiangsu and Henan) groups according to their geographical latitude and proximity of NAFLD concomitant rate. LFC was assessed by a quantitative ultrasound method. Multivariate regression models and analysis of covariance were used to assess the regional difference in the risk of NAFLD.
Results The concomitant rate of NAFLD was 23.3%, 44.0% and 55.3% in individuals with normal glucose tolerance (NGT), pre-diabetes and diabetes, respectively. A higher concomitant rate of NAFLD was found in the participants from the North comparing with the South group, regardless of glucose metabolism status (34.7% vs 16.2% in NGT, 61.5% vs 34.7% in pre-diabetes and 67.1% vs 48.1% in diabetes). This regional difference remained significant after adjustment for age, gender, alcohol drinking, cigarette smoking, confounding metabolic parameters and liver enzymes. For any given blood glucose, participants from the North had higher LFC than those from the South group.
Conclusions Half of Han Chinese with pre-diabetes/type 2 diabetes had NAFLD, and the individuals from the North cities were more susceptible to NAFLD.
- pre-diabetes
- liver fat
- type 2 diabetes
- non-alcoholic fatty liver disease
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Footnotes
MX and XS are joint first authors.
MX and XS contributed equally.
Contributors XG takes responsibility for the integrity of the work as a whole, from inception to published article. XG and HB designed the research study. HB, MX, LZ, YBi, QL, LS, FD, HL, DZ, YG, YBa, YW and LH performed the research. HB, MX and XS collected and checked the data. MX, BW and SW analyzed the data of quantitative liver ultrasonography. MX and XS analyzed the statistic data and wrote the paper, and XG and HB edited the manuscript. JG helped to revise the manuscript. All authors approved the final version of the manuscript.
Funding This work was supported by the financial support of National Natural Science Foundation of China (81471073 to HB).
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Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study protocol followed the guidelines of Research Ethics Committees of Zhongshan Hospital affiliated to Fudan University (approval number: 2011-6) and protocols in other involved hospitals were performed in accordance with the ethical principles of the Declaration of Helsinki and approved by local Research Ethics Committees.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.