2型糖尿病并发脂肪肝临床分析

Clinic analysis of fatty liver in patients with type 2 diabetes mellitus

目的分析2型糖尿病(T2DM)合并脂肪肝(FLD)的相关因素。方法采用对照研究的方法,观察156例T2DM伴有脂肪肝和不伴脂肪肝患者的体质指数(BMI)、空腹血糖(FBS)、餐后2小时血糖(PG2h)、糖化血红蛋白(HbA1C)、空腹胰岛素(FINS)、C-肽(C-P)、胰岛素敏感指数(ISI)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、胆固醇(TC)、高密度胆固醇(HDL)、低密度胆固醇(LDL)、载脂蛋白(Apo)、转氨酶(ALT)等指标,同时检查是否合并糖尿病的慢性并发症。结果与非脂肪肝组相比,T2DM合并脂肪肝组FBS、PG2h、HbA1C无差别(P>0.05);BMI、FINS、C-P、LDLTG、TC、ALT、HOMA-IR明显升高,HDL、ISI明显降低(P<0.05或P<0.01);大血管的并发症较多(P<0.05)。结论T2DM脂肪肝伴有较明显脂代谢紊乱及胰岛素抵抗,且大血管的并发症发生较多。

Objective To analyse the factors related to fatty liver in patients with type 2 diabetes mellitus. Methods Compared the serum concentrations of FBS, PG2h,HbA1C, FINS, C-P, ISI, HOMA-IR, TG, TC, HDL, LDL, Apolipoprotein, ALT and BMI in 78 type 2 diabetic patients with and 78 without fatty liver. Meanwhile, the prevalence of chronic complications including cardiovascular or cerebrovascular diseases was determined. Results There were not differences in the concentrations of FBS, PG2h, HbA1 C in T2DM with or without fatty liver(P>0.05). Patients with fat liver show higher concentrations of BMI,FINS,C-P,LDL,TG,TC,ALT,HOMA-IR; lower concentrations of HDL,ISI and more macrovascular complications(P<0.05 or P<0.01). Conclusion The fatty liver in T2DM is significantly associated with dyslipidemia and insulin resistance and macrovascular complications.