2型糖尿病合并非酒精性脂肪肝相关因素分析

A clinical study of relative factors in type 2 diabetes complicated with non alcoholic fatty liver disease

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并非酒精性脂肪肝(non alcoholic fatty liverdisease,NAFLD)的临床相关因素。方法:对新疆医科大学第五附属医院2008年1～6月的269例糖尿病住院患者进行回顾性分析,根据腹部B超结果分为合并NAFLD组148例,不合并NAFLD组121例。结果:与不合并NAFLD组比较,合并NAFLD的T2DM患者的体重指数(BMI)、腰围、血甘油三酯(TG)、低密度脂蛋白(LDL-C)、舒张压(DSP)显著增高(P均<0.05):同时高密度脂蛋白(HDL-C)显著降低(P<0.05);Logistic回归分析显示:BMI、DBP、TG、LDL-C、HDL-C对T2DM合并的NAFLD的发生有显著影响(P均<0.05)。结论:2型糖尿病患者合并非酒精性脂肪肝,与肥胖(主要是腹型肥胖)、血脂紊乱、血压增高相关;而与糖尿病病程、血糖控制程度、糖尿病并发症不相关,导致糖尿病合并非酒精性脂肪肝的最主要原因为胰岛素抵抗及其所包含的脂代谢紊乱。

Objective： To analyze the clinical relative factors in type 2 diabetes mellitus （T2DM） complicated with non alcoholic fatty liver disease. Methods： A total of 269 type 2 diabetes were selected in the Department of Endorcrinoloy, Five Affiliated Hospital, Xijiang Medical University, from January 2008 to June 2008. According to the color B-ultrasonography detection of liver and gall, these subjects were divided into fatty liver group （n = 148） and without fatty liver group （n =121）. Results： Compared with the T2DM patients without NAFLD, the figures of BMI, waistline （WL）, serum TG levels, serum LDL-C levels and diastolic blood pressure increased significantly in the T2DM patients with NAFLD （P 〈0.05）, while the serum HDL-C levels decreased significantly （P 〈0.05） ;Logistic regression analysis suggested that BMI, WL, DSP, TG, LDL C, HDL C were significantly effected of the forming of T2DM with NAFLD （P〈 0.05）. Conclusion： Obesity（ventro-type obesity）, dyslipidosis, blood pressure increased were remarkably correlated with T2DM with NAFLD; and course of diabetes disease, the degree of blood glucose control were not correlated with T2DM with NAFLD, insulin resistance and it cause of dyslipidosis are main reason of T2DM with NAFLD.