Browse > Article
http://dx.doi.org/10.7314/APJCP.2015.16.9.3931

Association between Diabetes Mellitus and Fatty Liver Based on Ultrasonography Screening in the World's Highest Cholangiocarcinoma Incidence Region, Northeast Thailand  

Thinkhamrop, Kavin (Doctor of Public Health Program, Khon Kaen University)
Khuntikeo, Narong (Department of Surgery, Faculty of Medicine, Khon Kaen University)
Phonjitt, Pichai (Department of Surgery, Faculty of Medicine, Khon Kaen University)
Chamadol, Nittaya (Department of Radiology, Faculty of Medicine, Khon Kaen University)
Thinkhamrop, Bandit (Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University)
Moore, Malcolm Anthony (Department of Epidemiology, Faculty of Public Health, Khon Kaen University)
Promthet, Supannee (Department of Epidemiology, Faculty of Public Health, Khon Kaen University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.16, no.9, 2015 , pp. 3931-3936 More about this Journal
Abstract
Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.
Keywords
Fatty liver; diabetes mellitus; ultrasonography; screening; Thailand;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Adami HO, Chow WH, Nyren O, et al (1996). Excess risk of primary liver cancer in patients with diabetes mellitus. J Natl Cancer Inst, 88, 1472-7.   DOI
2 Aekplakorn W, Stolk RP, Neal B, et al (2003). The prevalence and management of diabetes in Thai adults: the international collaborative study of cardiovascular disease in Asia. Diabetes Care, 26, 2758-63.   DOI
3 Browning JD, Szczepaniak LS, Dobbins R, et al (2004). Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatol, 40, 1387-95.   DOI
4 Cheung O, Sanyal AJ (2008). Hepatitis C infection and nonalcoholic fatty liver disease. Clin Liver Dis, 12, 573-85.   DOI
5 Deerochanawong C, Ferrario A (2013). Diabetes management in Thailand: a literature review of the burden, costs, and outcomes. Global Health, 9, 11.   DOI
6 Eguchi Y, Hyogo H, Ono M, et al (2012). Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2009 to 2010 in Japan: a multicenter large retrospective study. J Gastroenterol, 47, 586-95.   DOI
7 Fan JG (2007). [An introduction of strategies for the management of nonalcoholic fatty liver disease (NAFLD) recommended by Asia Pacific Working Party on NAFLD]. Zhonghua Gan Zang Bing Za Zhi, 15, 552-3.
8 Fan JG, Zhu J, Li XJ, et al (2005). Prevalence of and risk factors for fatty liver in a general population of Shanghai, China. J Hepatol, 43, 508-14.   DOI
9 Foster T, Anania FA, Li D, et al (2013). The prevalence and clinical correlates of nonalcoholic fatty liver disease (NAFLD) in African Americans: the multiethnic study of atherosclerosis (MESA). Dig Dis Sci, 58, 2392-8.   DOI
10 Fung J, Lee CK, Chan M, et al (2014). High prevalence of non-alcoholic fatty liver disease in the Chinese - results from the Hong Kong liver health census. Liver Int. (in press).
11 Hsing AW, Zhang M, Rashid A, et al (2008). Hepatitis B and C virus infection and the risk of biliary tract cancer: a population-based study in China. Int J Cancer, 122, 1849-53.
12 Hu X, Huang Y, Bao Z, et al (2012). Prevalence and factors associated with nonalcoholic fatty liver disease in Shanghai work-units. BMC Gastroenterol, 12, 123.   DOI
13 Jeong EH, Jun DW, Cho YK, et al (2013). Regional prevalence of non-alcoholic fatty liver disease in Seoul and Gyeonggi-do, Korea. Clin Mol Hepatol, 19, 266-72.   DOI
14 Jing W, Jin G, Zhou X, et al (2012). Diabetes mellitus and increased risk of cholangiocarcinoma: a meta-analysis. Eur J Cancer Prev, 21, 24-31.   DOI
15 Kim SH, Lee JW, Hwang HJ (2011). Associations between combinations of body mass index plus non-alcoholic fatty liver disease and diabetes mellitus among Korean adults. Asia Pac J Clin Nutr, 20, 14-20.
16 Leite NC, Salles GF, Araujo AL, et al (2009). Prevalence and associated factors of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus. Liver Int, 29, 113-9.   DOI   ScienceOn
17 Loomba R, Sanyal AJ (2013). The global NAFLD epidemic. Nat Rev Gastroenterol Hepatol, 10, 686-90.   DOI
18 Mohammad-Alizadeh AH, Ghobakhlou M, Shalmani HM, et al (2012). Cholangiocarcinoma: an-eight-year experience in a tertiary-center in Iran. Asian Pac J Cancer Prev, 13, 5381-4.   DOI
19 O'Shea RS, Dasarathy S, McCullough AJ, et al (2010). Alcoholic liver disease. Hepatol, 51, 307-28.   DOI
20 Palmer WC, Patel T (2012). Are common factors involved in the pathogenesis of primary liver cancers? A meta-analysis of risk factors for intrahepatic cholangiocarcinoma. J Hepatol, 57, 69-76.   DOI   ScienceOn
21 Shaib YH, El-Serag HB, Davila JA, et al (2005). Risk factors of intrahepatic cholangiocarcinoma in the United States: a case-control study. Gastroenterol, 128, 620-6.   DOI   ScienceOn
22 Shaw JE, Sicree RA, Zimmet PZ (2010). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract, 87, 4-14.   DOI
23 Shebl FM, Andreotti G, Meyer TE, et al (2011). Metabolic syndrome and insulin resistance in relation to biliary tract cancer and stone risks: a population-based study in Shanghai, China. Br J Cancer, 105, 1424-9.   DOI   ScienceOn
24 Shi L, Liu ZW, Li Y, et al (2012). The prevalence of nonalcoholic fatty liver disease and its association with lifestyle/dietary habits among university faculty and staff in Chengdu. Biomed Environ Sci, 25, 383-91.
25 Silva IdS (1999). Cancer Epidemiology: Principles and Methods. IARC Press.
26 StataCorp LP (2007). Stata Release 10: User's guide. College Station TX: Stata Press.
27 Suomela E, Oikonen M, Virtanen J, et al (2014). Prevalence and determinants of fatty liver in normal-weight and overweight young adults. The Cardiovascular Risk in Young Finns Study. Ann Med, 1-7.
28 Welzel TM, Graubard BI, El-Serag HB, et al (2007a). Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population-based case-control study. Clin Gastroenterol Hepatol, 5, 1221-8.   DOI
29 Wong VW, Wong GL, Chu WC, et al (2012). Hepatitis B virus infection and fatty liver in the general population. J Hepatol, 56, 533-40.   DOI
30 Welzel TM, Mellemkjaer L, Gloria G, et al (2007b). Risk factors for intrahepatic cholangiocarcinoma in a low-risk population: A nationwide case-control study. Int J Cancer, 120, 638-41.   DOI   ScienceOn
31 Wu Y, Ahmed A, Kamal A (2013). Donor diabetes mellitus is an independent risk factor for graft loss in HCV positive but not HCV negative liver transplant recipients. Dig Dis Sci, 58, 574-8.   DOI
32 Xiao SJ, Fu GJ, Lv YL, et al (2014). Prevalence and risk factors of fatty liver disease in young and middle-aged population: one center study in Southwestern China. J Gastroenterol Hepatol, 29, 358-64.   DOI
33 Yan Y, Bian H, Xia MF, et al (2013). Liver disease spectrum in hospitalized type 2 diabetes and related risk factors analysis of non-alcoholic fatty liver disease. Zhonghua Yi Xue Za Zhi, 93, 270-4 (in Chinese).