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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 于明暉(Ming-Whei Yu) | |
dc.contributor.author | Pei-Chen Ho | en |
dc.contributor.author | 何佩臻 | zh_TW |
dc.date.accessioned | 2021-06-08T02:50:06Z | - |
dc.date.copyright | 2017-09-14 | |
dc.date.issued | 2017 | |
dc.date.submitted | 2017-08-16 | |
dc.identifier.citation | 參考文獻
1. European Association for the Study of the Liver (EASL) , European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EASO). EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388–1402. 2. Liu CJ. Prevalence and risk factors for non-alcoholic fatty liver disease in Asian people who are not obese. J Gastroenterol Hepatol. 2012;27: 1555–1560. 3. Praveenraj P, Gomes RM, Kumar S, et al. Prevalence and predictors of non-alcoholic fatty liver disease in morbidly obese south Indian patients undergoing bariatric surgery. Obes Surg. 2015;25:2078–2087. 4. Singh SP, Kar SK, Panigrahi MK, et al. Profile of patients with incidentally detected nonalcoholic fatty liver disease (IDNAFLD) in coastal eastern India. Trop Gastroenterol. 2013;34:144–152. 5. Kwon HK, Greenson JK, Conjeevaram HS. Effect of lifetime alcohol consumption on the histological severity of non-alcoholic fatty liver disease. Liver Int. 2014;34(1): 129-135. 6. Sanyal AJ, American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease. Gastroenterology. 2002;123(5):1705–1725. 7. Marchesini G, Marzocchi R, Agostini F, et al. Nonalcoholic fatty liver disease and the metabolic syndrome. Curr Opin Lipidol. 2005;16(4):421–427. 8. Utzschneider KM, Utzschneider, Steven E. Kahn. The role of insulin resistance in nonalcoholic fatty liver disease. J Clin Endocrinol Metab. 2006;91(12):4753–4761. 9. Chalasani N, Youmossi Z, Lavine JE et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterol. 2012;142:1592–609. 10. Byrne CD, Trgher G. NAFLD: A multisystem disease. Journal of Hepatol. 2015; 62:S47–64. 11. Loomba R, Sanyal AJ. The global NAFLD epidemic. Nat Rev Gastroenterol Hepatol. 2013;10:686–690. 12. Singh S, Kuftinec GN, Sarkar S, et al. Non-alcoholic Fatty Liver Disease in South Asians: A Review of the Literature. J Clin Transl Hepatol. 2017;5:76–81. 13. Sullivan S, Kirk EP, Mittendorfer B, et al. Randomized Trial of Exercise Effect on Intrahepatic Triglyceride Content and Lipid Kinetics in Nonalcoholic Fatty Liver Disease. Hepatology. 2012;55(6):1738–1745. 14. Wong VW, Chan RS, Wong GL, et al. Community-based lifestyle modification programme for non-alcoholic fatty liver disease: A randomized controlled trial. J Hepatol. 2013;59:536–542. 15. Wheeler ML, Franz M, Barrier P, et al. Macronutrient and energy database for the 1995 exchange lists for meal planning: a rationale for clinical practice decisions. J Am Diet Assoc. 1996;96:1167–1171. 16. Imaizumi H, Takahashi A, Tanji N, et al. The association between sleep duration and non-alcoholic fatty liver disease among Japanese men and women. Obes Facts. 2015;8:234–242. 17. World Health Organization. Global report on diabetes. 2016. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf?ua=1 18. Zhang N, Du SM, Ma GS. Current lifestyle factors that increase risk of T2DM in China. Eur J Clin Nutr. 2017;71(7):832–838. 19. Chang YS, Jung HS, Yun KE, et al. Cohort study of non-alcoholic fatty liver disease, NAFLD fibrosis score, and the risk of incident diabetes in a Korean population. Am J Gastroenterol. 2013;108(12):1861–1868. 20. Miyake T, Hiroka M, Yoshida O, et al. Differences in the risk of fatty liver for onset of impaired fasting glucose according to baseline plasma glucose levels. J Gastroenterol. 2017;52(2):237–244. 21. Balkau B, Lange C, Vol S, et al. Nine-year incident diabetes is predicted by fatty liver indices: the French D.E.S.I.R. study. BMC Gastroenterol. 2010;10:56 22. Bedogni G, Bellentani S, Miglioli L, et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006;6:33. 23. Kotronen A, Peltonen M, Hakkarainen A, et al. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology. 2009;137(3):865–872. 24. Musso G, Gambino R, Durazzo M, et al. Noninvasive assessment of liver disease severity with liver fat score and CK-18 in NAFLD: Prognostic value of liver fat equation goes beyond hepatic fat estimation. Hepatology. 2010;51(2):715–717. 25. Yamazaki H, Tsuboya T, Tsuji K, et al. Independent association between improvement of nonalcoholic fatty liver disease and reduced incidence of type 2 diabetes. Diabetes Care. 2015;38(9):1673–1679. 26. Jarcuska P,Drazilova S, Fedacko J, et al. Association between hepatitis B and metabolic syndrome: Current state of the art. World J Gastroenterol. 2016;22(1): 155–164. 27. Cheng YL, Wang YJ, Kao WY, et al. Inverse association between hepatitis B virus infection and fatty liver disease: a large-scale study in populations seeking for check-up. PLoS One. 2013;8(8):e72049. 28. Wong VW, Wong GL, Chu WC, et al. Hepatitis B virus infection and fatty liver in the general population. J Hepatol. 2012;56(3):533–540. 29. Machado MV, Oliveira AG, Cortez-Pinto H. Hepatic steatosis in hepatitis B virus infected patients: meta-analysis of risk factors and comparison with hepatitis C infected patients. J Gastroenterol Hepatol. 2011;26(9):1361–1367. 30. Shen Y, Zhang J, Cai H, et al. Identifying patients with chronic hepatitis B at high risk of type 2 diabetes mellitus: a cross-sectional study with pair-matched controls. BMC Gastroenterol. 2015;15:32. 31. Chung TH, Kim MC, Kim CS. Association between hepatitis B surface antigen seropositivity and metabolic syndrome. Korean J Fam Med Sci. 2014;35(2):81–89. 32. Choi JS, Han KJ, Lee S, et al. Serum HBV surface antigen positivity is associated with low prevalence of metabolic syndrome in Korean adult men. J Epidemiol. 2015; 25(1):74–79. 33. Li WC, Lee YY, Chen IC, et al. Association between the hepatitis B and C viruses and metabolic diseases in patients stratified by age. Liver Int. 2013;33:1194–1202. 34. Basaranoglu M, Basaranoglu G. Pathophysiology of insulin resistance and steatosis in patients with chronic viral hepatitis. World J Gastroenterol. 2011;17(36): 4055-4062. 35. Moucari R, Asselah T, Cazals-Hatem D, et al. Insulin resistance in chronic hepatitis C: association with genotypes 1 and 4, serum HCV RNA level, and liver fibrosis. Gastroenterology. 2008; 134(2): 416-423. 36. Chu CJ, Hung TH, Hwang SJ, et al. Association of insulin resistance with hepatic steatosis and progression of fibrosis in Chinese patients with chronic hepatitis C. Hepatogastroenterology. 2008;55(88):2157–2161. 37. Zheng RD, Xu CR, Jiang L, et al. Predictors of hepatic steatosis in HBeAg-negative chronic hepatitis B patients and their diagnostic values in hepatic fibrosis. Int J Med Sci. 2010;7(5):272-277. 38. Minakari M, Molaei M, Shalmani HM, et al. Liver steatosis in patients with chronic hepatitis B infection: host and viral risk factors. Eur J Gastroenterol Hepatol. 2009; 21(5):512-516. 39. Nau AL, Soares JC, Shiozawa MB, et al. Clinical and laboratory characteristics associated with dyslipidemia and liver steatosis in chronicHBV carriers. Rev Soc Bras Med Trop. 2014;47(2):158-164. 40. Narciso-Schiavon JL, Schiavon Lde L, Carvalho-Filho RJ, et al. Clinical characteristics associated with hepatic steatosis on ultrasonography in patients with elevated alanine aminotransferase. Sao Paulo Med J. 2010;128(6):342-347. 41. Venturi C, Zoppini G, Zamboni C, et al. Insulin sensitivity and hepatic steatosis in obese subjects with normal glucose tolerance. Nutr Metab Cardiovasc Dis. 2004;14(4):200-204. 42. Yadav D, Choi E, Vogue S, et al. Fatty liver index as a simple predictor of incident diabetes from the KoGES-ARIRANG study. Medicine. 2016;95(31):e4447. 43. Hsiao PJ, Kuo KK, Shin SJ, et al. Significant correlations between severe fatty liver and risk factors for metabolic syndrome. J Gastroenterol Hepatol. 2007;22(12): 2118-2123. 44. Park SK, Seo MH, Shin HC, et al. Clinical availability of nonalcoholic fatty liver disease as an ealy predictor of type 2 diabetes mellitus in Korean men: 5-year prospective cohort study. Hepatology. 2013;57(4):1378-1383. 45. Bae JC, Rhee EJ, Lee WY, et al. Combined effect of nonalcoholic fatty liver disease and impaired fasting glucose on the development of type 2 diabetes: a 4-year retrospective longitudinal study. Diabetes Care. 2011;34(3):727-729. 46. Wang CC, Tseng TC, Hsieh TC, et al. Severity of fatty liver on ultrasound correlates with metabolic and cardiovascular risk. Kaohsiung J Med Sci. 2012; 28(3):151-160. 47. Shen HC, Zhao ZH, Hu YC, et al. Relationship between obesity, metabolic syndrome, and nonalcoholic fatty liver disease in the elderly agricultural and fishing population of Taiwan. Clin Interv Aging. 2014;9:501-508. 48. Rastogi A, Sakhuja P, Kumar A, et al. Steatosis in chronic hepatitis B: prevalence and correlation with biochemical, histologic, viral, and metabolic parameters. Indian J Pathol Microbiol. 2011;54(3):454-459. 49. de Vegt F, Dekker JM, Groeneveld WJ, et al. Moderate alcohol consumption is associated with lower risk for incident diabetes and mortality: the Hoorn Study. Diabetes Res Clin Pract. 2002;57(1):53-60. 50. Marques-Vidal P, Vollenweider P, Waeber G. Alcohol consumption and incidence of type 2 diabetes. Results from the CoLaus study. Nutr Metab Cardiovasc Dis. 2015;25(1):75-84. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/20478 | - |
dc.description.abstract | 背景與研究目標
過去較少對於亞洲所盛行的慢性B型肝炎病毒感染者研究血糖控制中脂肪肝所扮演角色的數據。本研究旨在慢性B型肝炎病毒感染男性的世代中,做初步縱式分析來探討脂肪肝持續性與血糖控制的關係。 材料與方法 本研究使用1989年至1992年在公保健診中心接受免費健康檢查的2878名B型肝炎表面抗原(hepatitis B surface antigen; HBsAg)陽性男性個案(進入研究時年齡為30至76歲)。在這些B型肝炎病毒帶原者中,納入本研究分析的為604位在2005至2009年間至少有來兩次健康檢查的無肝硬化的HBsAg陽性個案。脂肪肝是由腹部超音波來診斷,並根據第一次和最後一次測量時的圖像證據變化分為四個組別:兩次皆無、新發個案、轉歸無、持續有脂肪肝。血糖的部分根據世界衛生組織分為正常、空腹血糖異常(impaired fasting glucose; IFG)、糖尿病(diabetes mellitus; DM),切點分別為<100、100 - 125、≧126 mg/dL,也將問卷填答有無糖尿病一同定義。人口學資料、糖尿病家族史、飲酒與抽菸習慣是以標準化問卷訪問而來。每次來檢時測量身體質量指數(body mass index)、血壓、血清脂質水平及肝臟酵素。使用多變項羅吉斯回歸(multivariate logistic regression)來看脂肪肝與空腹血糖異常或糖尿病之風險比(odds ratio; OR)。 結果 在首次來檢時,平均年齡為61.7歲,年齡中位數為61歲。IFG及DM盛行率分別為10.9%及11.6% 。有脂肪肝的圖像證據者有236人(占604人當中的39.1%)。在平均追蹤3.2年期間,有54位(8.9%)新發脂肪肝個案,65位(10.8%)轉歸無脂肪肝者、171位(28.3%)持續有脂肪肝者。在單變項分析的部分,持續有脂肪肝與血糖升高(IFG或DM)有相關,相較於兩次皆無脂肪肝者其風險比(OR)為2.16 (95% 信賴區間=1.32-3.52,p值=0.0021)。經校正了首次來檢時年齡、BMI、三酸甘油脂、總膽固醇、高密度脂蛋白、收縮壓後,此關係仍存在,多變項校正後風險比(OR)為2.00 (95%信賴區間=1.08-3.72,p值=0.0277)。 結論 HBV帶原者持續有脂肪肝者相較於兩次檢查均無脂肪肝者,有較高的風險產生IFG或DM。 | zh_TW |
dc.description.abstract | Abstract
Background &Aims Few data exist regarding the role of fatty liver in glycemic control among individuals with chronic hepatitis B virus infection (HBV), which is prevalent in Asia-Pacific regions. This study aimed to conduct a preliminary analysis to evaluate the longitudinal relationship between persistence of fatty liver and glycemic control in a cohort of men with chronic HBV infection. Methods Data were obtained from a cohort of 2878 male, hepatitis B surface antigen-positive government employees (aged 30-65 years) who were recruited during free physical examination between 1989 and 1992. Of these HBV carriers, 604 who attended at least two check-up examinations between 2005 and 2009, and without liver cirrhosis were included for the present study. Fatty liver status was diagnosed by abdominal ultrasound and classified into four groups based on the image evidence at first and last measurement: none, developed, regressed, and persistence. According to World Health Organization criteria, fasting plasma glucose values of <100 , 100-125, and ≧126 mg/dL were defined normal, impaired fasting glucose (IFG), and diabetes mellitus (DM) , respectively. Demographics, history of diabetes mellitus, and habits of alcohol consumption and smoking were collected through standardized questionnaire interview. Body mass index, blood pressure, serum lipid levels, and liver enzymes were measured at each visit. Multivariate logistic regression was used to determine the odds ratio (OR) for fatty liver associated with IFG or DM. Results At first visit, the mean (median) age of study participants was 61.7 (61.0) years. The prevalence of IFG and DM was 10.9% and 11.6%, respectively. There were 236 of the 604 participants (39.1%) had image evidence of fatty liver. During the mean follow-up period of 3.2 years, we observed 54 (8.9%) new cases of fatty liver, and regression of fatty liver was found in 65 (10.8%). 171 (28.3%) had persistent fatty liver. In univariate analysis, persistence of fatty liver was associated with elevated blood sugar (IFG or DM), showing an OR of 2.16 (95% CI=1.32-3.52, p=0.0021), when comparing participants with persistent fatty liver with those without. This association remained statistically significant even after adjustment for age at first visit and body mass index, triglyceride (TG), total cholesterol, high density lipoprotein (HDL) and systolic blood pressure (SBP) change. The multivariate-adjusted OR was 2.00 (95% CI=1.08-3.72, p=0.0277). Conclusions Persistent fatty liver in HBV carriers have higher risk to develop IFG or DM, when comparing with those without fatty liver. | en |
dc.description.provenance | Made available in DSpace on 2021-06-08T02:50:06Z (GMT). No. of bitstreams: 1 ntu-106-R04849003-1.pdf: 1045633 bytes, checksum: d57cc74d8ff57325c9521fe0b72c90ec (MD5) Previous issue date: 2017 | en |
dc.description.tableofcontents | 目 錄
誌謝………………………………………..…………………………. .i 中文摘要……………………………………………..………………..ii 英文摘要………………………………………………………….…..iv 目錄…………………………………………………………………...vi 表目錄…………………………………………………………….….vii 第一章 研究背景………………………………………….…………1 第一節 脂肪肝……………………………………………..……1 第二節 糖尿病…………………………………………….….…3 第三節 脂肪肝與糖尿病之關聯…………………………….….3 第四節 B型肝炎與脂肪肝……………………………….…….5 第五節 C型肝炎與脂肪肝……………………………………..6 第六節 研究目的………………………………………….….....7 第二章 材料與方法……………………………………………….....8 第三章 結果……………………………………………………........11 第四章 討論………………………………………………………....14 第一節 各因子在血糖不同組別之盛行率....................14 第二節 脂肪肝及血糖異常(IFG/DM)之關係…………….......14 第三節 脂肪肝變化與血糖之關係……………………….…...16 第四節 脂肪肝變化與代謝症候群之關係....................17 第五節 變項之校正.....................................18 第六節 研究限制與優勢..............................19 第七節 總結.......................................20 參考文獻………………………………………………..…….……......21 表目錄 表一. 臺灣公保世代中之604位HBsAg男性帶原者於基線時(1989-1992年)之基本特徵…………………………………………………………………………..…26 表二-1. 2005-2009年追蹤期間的首次來檢時,依血糖分組看各因子之分佈……..27 表二-2. 2005-2009年追蹤期間的最後來檢時,依血糖分組看各因子之分佈…......29 表三-1. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢時的BMI、三酸甘油脂之分佈……………………………………………………………………....31 表三-2. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢時的總膽固醇、高密度脂蛋白之分佈….………………………………………………………..….32 表三-3. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢時的腰圍、腰臀比之分佈………………………………………………………………………........33 表三-4. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢時,代謝症候群之分佈……………………………………………………………………………....34 表三-5. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢時的血糖之分佈.....35 表四-1. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢的血糖變化…….....36 表四-2. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢的BMI變化、三酸甘油脂變化……………………………………………………………………...37 表四-3. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢的總膽固醇變化、高密度脂蛋白變化……………………………………………………………...38 表四-4. 依脂肪肝變化分組,2005-2009年追蹤期間兩次來檢時的腰圍變化、腰臀比變化………………………………………………………………………...39 表五-1. 限定在首次來檢時468位血糖正常且無IFG或DM者,2005-2009年追蹤期間,脂肪肝及其他代謝相關因子之變化,與血糖升高(IFG或DM)的相對危險性…………………………………………………………………….......40 表五-2. 限定在首次來檢時468位血糖正常且無IFG或DM者,2005-2009年追蹤期間,首次脂肪肝及代謝相關的因子,與血糖升高(IFG或DM)的相對危險性….……………………………………………………………………..…....42 表五-3. 限定在首次來檢時468位血糖正常且無IFG或DM者,2005-2009年追蹤期間,首次脂肪肝及代謝症候群組成因子個數,與血糖升高(IFG或DM)的相對危險性…….………………………………………………………….….44 表五-4. 限定在首次來檢時468位血糖正常且無IFG或DM者,2005-2009年追蹤期間,末次脂肪肝程度及首次代謝症候群組成因子個數,與血糖升高(IFG或DM)的相對危險性………………….…………………………………..…45 | |
dc.language.iso | zh-TW | |
dc.title | 男性B型肝炎帶原者脂肪肝與血糖控制之縱貫性研究:臺灣公保健診中心世代初步分析 | zh_TW |
dc.title | Longitudinal Relationship between Fatty Liver and Glycemic Control in Male Hepatitis B Carriers: Report from A Preliminary Analysis of the Taiwanese Government Employee Central Clinics (GECC) Cohort | en |
dc.type | Thesis | |
dc.date.schoolyear | 105-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 鄭尊仁(Tsun-Jen Cheng),林志陵(Chih-Ling Lin),黃奕文(Yi-wen Huang) | |
dc.subject.keyword | 脂肪肝,血糖,B型肝炎帶原者, | zh_TW |
dc.subject.keyword | fatty liver,glucose,hepatitis B virus carrier, | en |
dc.relation.page | 45 | |
dc.identifier.doi | 10.6342/NTU201703594 | |
dc.rights.note | 未授權 | |
dc.date.accepted | 2017-08-16 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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