2型糖尿病非酒精性脂肪性肝病与胰岛素抵抗的相关性分析

The relationship between insulin resistance and type 2 diabetes with nonalcoholic fatty liver disease

目的探讨在2型糖尿病(T2DM)合并非酒精性脂肪性肝病与胰岛素抵抗的关系。方法将195例2型糖尿病患者分为单纯糖尿病组(A组)83例,合并非酒精性脂肪肝组(B组)60例及合并非酒精性脂肪性肝炎组(C组)52例,分别测定身高、体质量,抽空腹血检查总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、糖化血红蛋白(HbA1C)、空腹血糖(FBG)及空腹胰岛素(FINS)等。计算体质量指数(BMI)及胰岛素抵抗指数(HOMA-IR)。结果 BMI、TG、TC、LDL-C、ALT、AST、GGT、FINS、HOMA-IR水平显示:B组均明显高于A组(P<0.05),C组均明显高于B组(P<0.05)。而HDL-C水平显示:B组均明显低于A组(P<0.05),C组均明显低于B组(P<0.05)。3组间HbA1C、FBG及年龄比较,差异无统计学意义。相关分析显示:HOMA-IR与BMI、TG、TC、LDL-C呈显著正相关(P<0.01),与HDL-C呈显著负相关(P<0.01)。结论胰岛素抵抗是T2DM合并非酒精性脂肪性肝病的危险因素,并且与BMI、TG、TC、LDL-C、HDL-C水平具有相关性。

Objective To investigate the relationship between insulin resistance and type 2 diabetes （T2DM） with nonalcoholic fatty liver disease（NAFLD）. Methods 195 patients with new diagnosised T2DM were divided into three groups,83 diabetes without NAFLD（group A）,60 diabetes with NAFL（group B）and 52 diabetes with NASH（group C）. The level of height,weight,cholesteroltotal（TC）, triglyceride（ TG）, high density lipoprotein（ HDI. C）, low density lipoprotein（LDL C）, alanine aminotransferaseglycated（ALT）, aspertate aminotransferase（ AST）, alutamyl transpeptidase（GGT）, hemoglobin（HbA1C） and fasting insulin （FINS） were measured. Body mass index （BMI） and index of insulin resistance（HOMA IR） were calculated. Results The level of BMI, TG,TC,LDL C,ALT,AST,GGT,FINS, HOMA-IR： group B was significantly higher than group A （P〈0.05） ,and group C was significantly higher than group B（P〈0.05）. The level of HDI. C： group B was significantly lower than group A （P〈0.05） ,and group C was significantly lower than group B（P〈0.05）. The level of H（）MA IR was positive correlated with BMI, TG, TC, LDL- C（P〈0.01） ,and was negative correlated wilh HDI. C（P〈0.01 ）. Conclusion Insulin resistance is risk factor in type 2 diabetes with NAFLD and is correlated with BM1, TG, TC, LDLC, HDL-C.