2型糖尿病合并脂肪肝的危险因素研究

Study on Risk Factors of Type 2 Diabetes Associated with Fatty Liver

目的:探讨影响糖尿病合并脂肪肝的主要危险因素。方法:采用病例对照研究,2型糖尿病伴有脂肪肝(DFL)组1 1 8例,2型糖尿病不伴脂肪肝(NDFL)组1 4 9例,非糖尿病非酒精性脂肪肝(NDNASH)组5 5例。结果:⑴与DFL有关的危险因素包括体重指数、腰臀比值、血压、空腹胰岛素、餐后2h胰岛素、胆固醇、甘油三酯、HOMA -IR ,其中最主要的两个危险因素是腰臀比值、甘油三酯;⑵DFL组与NDFL组比较,空腹血糖、餐后2h血糖、糖化血红蛋白(HbA1C)无显著差异性;( 3 )NDFL与NDNASH组比较,HOMA -IR差异无显著性。结论:( 1 )影响DFL的因素众多,主要因素是腰臀比值、甘油三酯;( 2 )血糖对DFL发病作用降低;( 3 )脂肪肝可能是糖尿病前一个阶段。

Objective: To explore the risk factors associated with diabetic fatty liver(DFL). Methods: The investigation was conducted by means of case control study,including 118 patients of type 2 diabetes with fatty liver(DFL),149 type 2 diabetes without fatty liver(NDFL),55 nondiabetic nonalcoholic steatohepatitis(NDNASH). Results: ⑴Risk factors related to DFL including BMI,WHR,SBP,DBP,FINS,PINS,TC,TG and HOMA-IR.WHR and TG were the most important of all above variables. ⑵There were not significant differences between DFL and NDFL groups on FBG,P2hBG,HbA_(1C). ⑶There was not significant difference between NDFL and NDNASH groups on HOMA-IR. Conclusion: ⑴The risk factors of DFL includes BMI,WHR,SBP,DBP,FINS,PINS,TC,TG and HOMA-IR. WHR and TG are the most important factors of all. ⑵Effects of plasma glucose on DFL in diabetic patients are decreased. ⑶Fatty liver was probably one prediabetic stage, DFL was probably one of components of matebolic syndrome.