Vuorinen, M;
Männistö, VT;
Salomaa, V;
Britton, A;
Jula, A;
Männistö, S;
Lundqvist, A;
... Åberg, F; + view all
(2022)
Attribution of diabetes to the development of severe liver disease in the general population.
Liver International
10.1111/liv.15296.
(In press).
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Abstract
Background and Aims: Diabetes is associated with advanced liver disease and predicts mortality regardless of the primary aetiology of the liver disease. Even a family history of diabetes has been linked to advanced liver fibrosis in non-alcoholic fatty liver disease (NAFLD). However, the fraction of liver-related outcomes in the general population that are attributable to diabetes remains unclear. Methods: The population attributable fraction (PAF) of diabetes for liver disease as a time-dependent exposure was estimated in the Finnish FINRISK study (n = 28 787) and the British Whitehall II study (n = 7855). We also assessed the predictive ability of a family history of diabetes for liver-related outcomes. Incident diabetes data were from drug purchase/reimbursement and healthcare registries (FINRISK) or follow-up examinations (Whitehall II). Incident severe liver outcomes were identified through linkage with national healthcare registries. Results: Diabetes was associated with a two-fold risk of liver-related outcomes in both the FINRISK (HR, 1.92; p <.001) and Whitehall II (HR, 2.37; p <.001) cohorts, and this remained significant after adjusting for multiple confounders. PAF analyses demonstrated that diabetes explained 12–14% of the risk for severe liver-related outcomes after 10 and 20 years of follow-up. Also, maternal diabetes increased the risk of liver-related outcomes in the FINRISK (HR, 1.43; p =.044) and Whitehall II (HR, 2.04; p =.051) cohorts. Conclusion: Approximately 12%–14% of severe liver-related outcomes are attributable to diabetes at the population level. The association between maternal diabetes and liver disease might suggest a mitochondrial genetic mechanism.
| Type: | Article |
|---|---|
| Title: | Attribution of diabetes to the development of severe liver disease in the general population |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/liv.15296 |
| Publisher version: | https://doi.org/10.1111/liv.15296 |
| Language: | English |
| Additional information: | © 2022 The Authors. Liver International published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | cirrhosis, hepatology, hyperglycaemia |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10149912 |
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