2型糖尿病合并非酒精性脂肪肝病患者血脂代谢与冠心病的关系

Relationship between Lipid Metabolism and Coronary Heart Disease in Patients with Type Ⅱ Diabetic Combined with Nonalcoholic Fatty Liver Disease

目的:探讨2型糖尿病合并非酒精性脂肪肝病(NAFLD)患者的血脂谱特点及其与冠心病的关系。方法:对我院收治的2型糖尿病患者492例根据病史及肝脏B超检查结果分为NAFLD组和非NAFLD组,观察其血脂谱特点及其与冠心病患病率的关系。结果:341例(69.3%)住院2型糖尿病患者伴NAFLD,其中259例(76.0%)肝功能正常且无明显症状;NAFLD组有较高的丙氨酸转氨酶(ALT)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平,与非NAFLD组比较,差异有显著性(P<0.01);NAFLD组冠心病患病率明显高于非NAFLD组,差异有显著性(P<0.01),其中ALT升高组冠心病的患病率较ALT正常者升高,差异亦有显著性(P<0.05)。结论:2型糖尿病患者NAFLD发生率高,且大多数无症状,其发生可能与体脂分布异常、血脂代谢紊乱等因素相关,NAFLD增加了2型糖尿病患者冠心病的风险,ALT可作为其预测指标。

Objective：To assess the relationship between lipid metabolism and coronary heart disease（CHD） m patienrs with Type Ⅱ diabetic combined with nonalcoholic fatty liver disease. Methods ：The 492 padentsrelinieal data were collected since 2002. and they were divided into two groups （NAFLD-Group and non-NAFLD group） by liver ultrasoriography. Results ：Among them. 341 cases （69.3 % ） were complicated with NAFLD. and 259 cases （76 % ） had normal liver function and no symptom ;NAFLD group had higher alanine aminotransferase （ALT）.triglyeerides （TG） and low density lipoprotein lipoprotein cholesterol （LDL-C） levels than those without NAFLD（P〈0.01 ） ; Moreover. the prevalence of CHD was also higher in NAFLD group, especially in those with elevated plasma ALT （P〈0. ）5）. Conclusion： NAFLD is acommon condition complicated with Type 2 diabetes, the occurrences may be related with abdominal obesity, dyslipi demia metabolism： NAFLD increases the risk of CHD and plasma ALT levels may be acted as a marker.