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- 저자 : Matteo Nazzareno Barbaglia (검색결과 1 건)
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Mattia Bellan,Cosimo Colletta,Matteo Nazzareno Barbaglia,Livia Salmi,Roberto Clerici,Venkata Ramana Mallela,Luigi Mario Castello,Giuseppe Saglietti,Gian Piero Carnevale Schianca,Rosalba Minisini,Mario 대한당뇨병학회 2019 Diabetes and Metabolism Journal Vol.43 No.5
Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM) ishigh, though its severity is often underestimated. Our aim is to provide an estimate of the prevalence of severe NAFLD in T2DMand identify its major predictors. Methods: T2DM patients (n=328) not previously known to have NAFLD underwent clinical assessment, transient elastographywith measure of liver stiffness (LS) and controlled attenuation parameter (CAP), and genotyping for patatin like phospholipasedomain containing 3 (PNPLA3) and 17β-hydroxysteroid-dehydrogenase type 13 (HSD17B13). Results: Median LS was 6.1 kPa (4.9 to 8.6). More than one-fourth patients had advanced liver disease, defined as LS ≥7.9 kPa(n=94/238, 29%), and had a higher body mass index (BMI) than those with a LS <7.9 kPa. Carriage of the G allele in the PNPLA3gene was associated with higher LS, being 5.9 kPa (4.7 to 7.7) in C/C homozygotes, 6.1 kPa (5.2 to 8.7) in C/G heterozygotes, and6.8 kPa (5.8 to 9.2) in G/G homozygotes (P=0.01). This trend was absent in patients with ≥1 mutated HSD17B13 allele. In a multiplelinear regression model, BMI and PNPLA3 genotype predicted LS, while age, gender, disease duration, and glycosylated hemoglobindid not fit into the model. None of these variables was confirmed to be predictive among carriers of at least one HSD17B13mutated allele. There was no association between CAP and polymorphisms of PNPLA3 or HSD17B13. Conclusion: Advanced NAFLD is common among T2DM patients. LS is predicted by both BMI and PNPLA3 polymorphism,the effect of the latter being modulated by mutated HSD17B13.
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