Journal
DIABETES CARE
Volume 41, Issue 2, Pages 341-347Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc17-1590
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Funding
- Scottish Government through the Scottish Diabetes Group
- NHS Research Scotland, a partnership of Scottish NHS Boards
- Chief Scientist Office of the Scottish Government
- European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative Joint Undertaking [115372]
- Southampton National Institute for Health Research Biomedical Research Centre
- MRC [MR/P008348/1] Funding Source: UKRI
- Chief Scientist Office [PDF/15/07] Funding Source: researchfish
- Medical Research Council [MR/P008348/1] Funding Source: researchfish
- National Institute for Health Research [CL-2015-12-503] Funding Source: researchfish
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OBJECTIVE To describe associations between alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS We performed a retrospective cohort study by using linked population-based routine data from diabetes registry, hospital, cancer, and death records for people aged 40-89 years diagnosed with T2DM in Scotland between 2004 and 2013 who had one ormore hospital admission records. Liver disease and outcomes were identified by using ICD-9 and ICD-10 codes. We estimated hazard ratios (HRs) from Cox proportional hazards regression models, adjusting for key risk factors. RESULTS A total of 134,368 people with T2DM (1,707 with ALD and 1,452 with NAFLD) were studied, with a mean follow-up of 4.3 years for CVD and 4.7 years for mortality. Among those with ALD, NAFLD, or without liver disease hospital records 378, 320, and 21,873 CVD events; 268, 176, and 15,101 cancers; and 724, 221, and 16,203 deaths were reported, respectively. For ALD and NAFLD, respectively, adjusted HRs (95% CIs) compared with the group with no record of liver disease were 1.59 (1.43, 1.76) and 1.70 (1.52, 1.90) for CVD, 40.3 (28.8, 56.5) and 19.12 (11.71, 31.2) for hepatocellular carcinoma (HCC), 1.28 (1.12, 1.47) and 1.10 (0.94, 1.29) for non-HCC cancer, and 4.86 (4.50, 5.24) and 1.60 (1.40, 1.83) for all-cause mortality. CONCLUSIONS Hospital records of ALD or NAFLD are associated to varying degrees with an increased risk of CVD, cancer, and mortality among people with T2DM.
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