Severity of fatty liver is highly correlated with the risk of hypertension and diabetes: a cross-sectional and longitudinal cohort study

BACKGROUND AND AIMS

Fatty liver disease (FLD) is associated with several metabolic derangements. We conducted a retrospective cross-sectional and longitudinal study to evaluate the role of FL severity in the risk of new-onset and co-existing hypertension (HTN) and diabetes mellitus (DM).

METHODS

The cross-sectional cohort consisted of 41,888 adults who received health checkups in a tertiary hospital of Taiwan from 1999 to 2013. Of them, 34,865 without HTN and/or DM at baseline and within 1 year after enrollment were included as a longitudinal cohort (mean, 6.45 years for HTN; 6.75 years for DM). FL severity based on the degree of hepatic steatosis was assessed by ultrasound sonography.

RESULTS

In cross-sectional cohort, 22,852 (54.6%) subjects had FL (18,203 [43.46%] mild FL and 4,649 [11.10%] moderate/severe FL); 13.5% (n = 5668) had HTN; and 3.4% (n = 1411) had DM. Moderate/severe FL and mild FL had significantly higher risks of existing HTN (adjusted odds ratio/95% confidence interval [CI] 1.59/1.43-1.77 and 1.22/1.13-1.32, respectively). In longitudinal cohort, 3,209 and 822 subjects developed new-onset HTN and DM, respectively (annual incidence, 14.3 and 3.5 per 1000 person-years; 10-year cumulative incidence, 14.35% and 3.89%, respectively). Moderate/severe and mild FL had significantly higher risks of new-onset HTN (adjusted hazard ratio [aHR]/CI 1.54/1.34-1.77 and 1.26/1.16-1.37, respectively) and DM (aHR/CI 5.88/4.44-7.81 and 3.22/2.56-4.07, respectively). Resolved FL during follow-up decreased the risk of HTN and/or DM.

CONCLUSIONS

Patients with FL are at high risk of prevalent and incident HTN and/or DM. The risk increases with the severity of FL.

Automatic mass-rearing of Amblyseius womersleyi (Acari: Phytoseiidae)

Using incorporated devices, Tetranychus urticae spider mites were rinsed from hydroponically-grown lima bean plants, collected, separated and blow-dried. This yielded a reliable and large volume of eggs and larvae, which were fed to Amblyseius womersleyi rearings on 15 x 5 cm2 polyethylene arenas. Of several feeding regimes tested, daily feeding of 10 mg T. urticae eggs and larvae resulted in the highest predator population levels. The best harvest period was between 15 and 27 days, when predator density exceeded 600 mites per arena. A preliminary automatic mass-rearing device was tested for A. womerslyi. This incorporated both rearing and harvesting procedures. A micro-feeder was developed to supply the required volume of spider mites and maize pollen (1:1 mixture) to the predators. A Bakelite rearing arena reduced the space requirements of a polyethylene arena, was more durable and an essential component in the automatic mass-rearing and harvesting. Mite harvesting is carried out through the use of a vacuum-head harvester. Supplements of (sterilized) spider mites, pollen, vermiculite and wheat bran are automatically added to the predators. The devices for harvesting, filling and packing are incorporated and synchronized and the entire system is controlled by a single slide-switch. The design and system can be expanded without changing the basic processes and program, for example to adopt it for other species of predaceous mites.