title: Association between Diabetes Mellitus and Fatty Liver Based on Ultrasonography Screening in the World's Highest Cholangiocarcinoma Incidence Region, Northeast Thailand.
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 (±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.
authors.affiliation: Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Thailand E-mail : supannee@kku.ac.th.
authors.forename: Kavin
authors.initials: K
authors.lastname: Thinkhamrop
authors.forename: Narong
authors.initials: N
authors.lastname: Khuntikeo
authors.forename: Pichai
authors.initials: P
authors.lastname: Phonjitt
authors.forename: Nittaya
authors.initials: N
authors.lastname: Chamadol
authors.forename: Bandit
authors.initials: B
authors.lastname: Thinkhamrop
authors.forename: Malcolm Anthony
authors.initials: MA
authors.lastname: Moore
authors.forename: Supannee
authors.initials: S
authors.lastname: Promthet
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D018281:Cholangiocarcinoma / Q000150:complications* / Q000000981:diagnostic imaging; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D013785:Thailand; D014463:Ultrasonography