Objective: To determine whether the incidence/adverse outcomes of hepatobiliary disease (HPD) has increased over recent decades in community-based Australians.
Methods: Longitudinal data from the Fremantle Diabetes Study Phase I (FDS1; recruitment 1993-1996) and Phase II (FDS2; 2008-2011) were analyzed. Participants with type 2 diabetes from both Phases were age-, sex- and zip code-matched 1:4 to people without diabetes. Incident HPD and associated mortality were ascertained from hospitalization, cancer registration and/or death certification for an ICD-coded diagnosis (principal/secondary) of liver disease, viral hepatitis, primary malignancy, and gallbladder/biliary tract disease. Incidence rates (IRs) and IR ratios (IRRs) for those with versus without diabetes in FDS1 and FDS2 were calculated.
Results: Data relating to IRs for HPD and associated mortality are shown in the Table. HPD IRs for people without diabetes did not change between Phases but the IRR increased, reflecting an IRR (95% CI) for people with diabetes in FDS2 versus FDS1 of 1.30 (1.01-1.68). Nonalcoholic fatty liver disease/steatohepatitis (NAFLD/NASH) accounted for <20% of HPD and <10% of liver-related deaths in both Phases.
Conclusions: HPD is more frequent in people with versus without type 2 diabetes. This discrepancy has increased in the 15 years between FDS Phases. Hospitalizations/deaths due to NAFLD/NASH remain uncommon.
T. Davis: Advisory Panel; Self; Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S. Speaker’s Bureau; Spouse/Partner; Boehringer Ingelheim International GmbH. Speaker’s Bureau; Self; Lilly Diabetes, Merck Sharp & Dohme Corp., Mylan, Novo Nordisk A/S, Sanofi-Aventis. Other Relationship; Self; Protemics International. Other Relationship; Spouse/Partner; Protemics International. W.A. Davis: Advisory Panel; Spouse/Partner; Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S. Speaker’s Bureau; Self; Boehringer Ingelheim International GmbH. Speaker’s Bureau; Spouse/Partner; Lilly Diabetes, Merck Sharp & Dohme Corp., Mylan, Novo Nordisk A/S, Sanofi-Aventis. Other Relationship; Self; Proteomics International. Other Relationship; Spouse/Partner; Proteomics International.
Raine Foundation; University of Washington; National Health and Medical Research Council (513781, 1042231); Medical Research Future Fund Practitioner Fellowship