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논문 기본 정보

자료유형
학술저널
저자정보
Teruki Miyake (Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine) Shinya Furukawa (Health Services Center, Ehime University) Bunzo Matsuura (Ehime University Graduate School of Medicine) Yoshida Osamu (Ehime University Graduate School of Medicine) Masumi Miyazaki (Ehime University Graduate School of Medicine) Akihito Shiomi (Ehime University Graduate School of Medicine) Ayumi Kanamoto (Ehime University Graduate School of Medicine) Hironobu Nakaguchi (Ehime University Graduate School of Medicine) Yoshiko Nakamura (Ehime University Graduate School of Medicine) Yusuke Imai (Ehime University Graduate School of Medicine) Mitsuhito Koizumi (Ehime University Graduate School of Medicine) Takao Watanabe (Ehime University Graduate School of Medicine) Yasunori Yamamoto (Ehime University Graduate School of Medicine) Yohei Koizumi (Ehime University Graduate School of Medicine) Tokumoto Yoshio (Ehime University Graduate School of Medicine) Masashi Hirooka (Ehime University Graduate School of Medicine) Kumagi Teru (Ehime University Graduate School of Medicine) Eiji Takesita (Ehime University Graduate School of Medicine) Yoshio Ikeda (Ehime University Graduate School of Medicine) Masanori Abe (Ehime University Graduate School of Medicine) Yoichi Hiasa (Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine)
저널정보
대한당뇨병학회 Diabetes and Metabolism Journal Diabetes and Metabolism Journal Vol.48 No.3
발행연도
2024.5
수록면
440 - 448 (9page)
DOI
10.4093/dmj.2023.0200

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Background: Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.Methods: This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%.Results: Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.Conclusion: Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.

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