新诊断2型糖尿病并非酒精性脂肪肝的相关因素分析

Related Factors for Newly Diagnosed Type 2 Diabetes Mellitus Patients with Nonalcoholic Fatty Liver Disease

目的:探讨新诊断2型糖尿病患者(T_2DM)并非酒精性脂肪肝(NAFLD)的相关因素。方法:比较新诊断T_2DM并NAFLD(DFL)和未合并NAFLD(NDFL)患者的各种生化指标,Logistic回归方法分析T_2DM并NAFLD的相关因素。结果:与NDFL组相比较,DFL组的体重指数(BMI)、腰围、谷丙转氨酶(ALT)、谷草转氨酶(AST)、Ln(C肽曲线下面积)[Ln(CPAUC)]、甘油三脂(TG)和尿酸明显增高(P<0.05);DFL组腰围≥85 cm,BMI≥25 kg/m^2,血脂异常、尿酸≥350μmol/L,代谢综合征和Ln(CPAUC)≥12的患者比例明显高于NDFL组(P<0.05);Logistic回归分析显示:腰围≥85 cm和Ln(CPAUC)≥12是新诊断T_2DM并NAFLD的独立危险因素(P<0.05)。结论:新诊断T_2DM患者的NAFLD与各种代谢异常密切相关,胰岛素抵抗是其主要的危险因素,反映中心性肥胖的腰围可作为其一个重要的预测因素。

Objective： To investigate the related factors for newly diagnosed type 2 diabetes mellitus （T2DM） patients with nonalcoholic fatty liver disease （NAFLD）. Method： Biochemical indices between newly diagnosed T2DM patients with and without NAFLD （DFL and NDFL） were compared. The related factors for newly diagnosed T2DM patients with NAFLD were analyzed by Logistic analysis. Results： Compared with NDFL group,the BMI,waist circumference,ALT,AST,Ln （CPAUC）, triglycerid and uric acid in DFL group were significantly higher （P〈0.05）. The patients with waist circumference ≥85 cm,BMI ≥25 kg/m2,dyslipidemia,uric acid ≥350 μmol/L,metabolic syndrome and Ln （CPAUC）≥ 12 in DFL group were significantly more than those in NDFL group （P〈O.05）. Waist circumference ≥ 85 cm and Ln （CPAUC） were independent risk factors for newly diagnosed T2DM patients with NAFLD by Logistic analysis（P〈0.05）. Conclusion： NAFLD in newly diagnosed T2DM patients has close relationship with all kinds of metabolic abnormality. Insulin resistance is the major risk factor for newly diagnosed T2DM patients with NAFLD. Waist circumference, as an indirect factor for central obesity, may be an important predictive factor for NAFLD in newly diagnosed T2DM patients.