Context: Patients with diabetes are at increased risk of dying from liver-related events, but little is known on whether this increased risk changed in recent years. Objective: The aim of the present study is to describe time trends in cause-specific liver-related mortality in people with and without diabetes from the general Italian population. Methods: Data were retrieved from the healthcare utilization databases of Lombardy, a region of Italy that accounts for about 16% (almost ten million) of its population. Annual cause-specific mortality rates and proportionate mortality were computed among individuals with and without diabetes from 2010 to 2019. Liver-related deaths were categorized as viral, alcohol related and non-viral non-alcohol related (NVNA). Results: Liver diseases were responsible for 2% and 1% of deaths in people with and without diabetes (2019). Among patients with diabetes, the crude mortality rate for liver diseases decreased from 1.13 to 0.64 deaths per 1,000 person-years from 2010 to 2019. The largest proportion of liver-related deaths was attributable to NVNA diseases and it increased from 63% in 2010 to 68% in 2019, with a corresponding relative reduction of viral causes (from 27% to 23%). The Standardized Mortality Ratio for patients with diabetes was 3.35 (95% CI 2.96-3.76) for NVNA, 1.66 (95% CI 1.33-2.01) for viral hepatitis and 1.61 (95% CI 1.13-2.17) for alcoholic liver disease and it remained relatively stable over time. Excess mortality risk in patients with diabetes for liver-related mortality was higher than for cardiovascular mortality and cancer. Conclusion: While liver-related mortality rates decreased significantly among patients with diabetes, NVNA causes comprised the majority of cases. Excess mortality for liver-related causes in patients with diabetes compared with controls remained constant in the studied period.

Ciardullo, S., Morabito, G., Rea, F., Savaré, L., Perseghin, G., Corrao, G. (2024). Time trends in liver-related mortality in people with and without diabetes: Results from a population based study. THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM [10.1210/clinem/dgae182].

Time trends in liver-related mortality in people with and without diabetes: Results from a population based study

Ciardullo, Stefano
Primo
;
Morabito, Gabriella;Rea, Federico;Perseghin, Gianluca;Corrao, Giovanni
Ultimo
2024

Abstract

Context: Patients with diabetes are at increased risk of dying from liver-related events, but little is known on whether this increased risk changed in recent years. Objective: The aim of the present study is to describe time trends in cause-specific liver-related mortality in people with and without diabetes from the general Italian population. Methods: Data were retrieved from the healthcare utilization databases of Lombardy, a region of Italy that accounts for about 16% (almost ten million) of its population. Annual cause-specific mortality rates and proportionate mortality were computed among individuals with and without diabetes from 2010 to 2019. Liver-related deaths were categorized as viral, alcohol related and non-viral non-alcohol related (NVNA). Results: Liver diseases were responsible for 2% and 1% of deaths in people with and without diabetes (2019). Among patients with diabetes, the crude mortality rate for liver diseases decreased from 1.13 to 0.64 deaths per 1,000 person-years from 2010 to 2019. The largest proportion of liver-related deaths was attributable to NVNA diseases and it increased from 63% in 2010 to 68% in 2019, with a corresponding relative reduction of viral causes (from 27% to 23%). The Standardized Mortality Ratio for patients with diabetes was 3.35 (95% CI 2.96-3.76) for NVNA, 1.66 (95% CI 1.33-2.01) for viral hepatitis and 1.61 (95% CI 1.13-2.17) for alcoholic liver disease and it remained relatively stable over time. Excess mortality risk in patients with diabetes for liver-related mortality was higher than for cardiovascular mortality and cancer. Conclusion: While liver-related mortality rates decreased significantly among patients with diabetes, NVNA causes comprised the majority of cases. Excess mortality for liver-related causes in patients with diabetes compared with controls remained constant in the studied period.
Articolo in rivista - Articolo scientifico
NAFLD; diabetes; epidemiology; liver mortality
English
20-mar-2024
2024
open
Ciardullo, S., Morabito, G., Rea, F., Savaré, L., Perseghin, G., Corrao, G. (2024). Time trends in liver-related mortality in people with and without diabetes: Results from a population based study. THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM [10.1210/clinem/dgae182].
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