非酒精性脂肪性肝病患者空腹血糖分布特点的研究

Characteristics of fasting glucose distribution of the patients with non-alcoholic fatty liver disease

目的探讨非酒精性脂肪性肝病(NAFLD)患者FPG分布的特点。方法按照2010年非酒精性脂肪性肝病诊疗指南纳入356例NAFLD患者(NAFLD组),以同期在我院体检的非脂肪肝人群256名为对照(NC)组。受试者测定血糖、TG、谷丙转氨酶(ALT)及计算BMI进行组间比较,对NAFLD组不同TG、BMI水平患者的血糖进行比较。结果 NAFLD组血糖、TG、BMI、ALT均明显高于NC组(P<0.01);NAFLD组FPG<5.6mmol/L例数明显少于NC组,IFG及糖尿病例数明显多于NC组(P<0.01);合并TG升高、肥胖的NAFLD患者血糖较NC组明显增高(P<0.01)。结论 NAFLD患者FPG异常的检出率明显高于非NAFLD患者,高TG血症、肥胖可能进一步促进NAFLD患者血糖异常的发生。

Objective To investigate the characteristics of fasting glucose distribution of the patients with non-alcoholic fatty liver disease （NAFLD）. Methods The 356 NAFLD patients diagnosed by ultra- sonography entered the study according to the guideline of the diagnosis and treatment of NAFLD pub- lished by Chinese Medical Association in 2010, and other 256 subjects without fatty liver disease were taken as controls. Serum glucose, triglyceride （TG）, and alanine aminotransferase （ALT） were deter- mined, and body weight and height were measured to assess body mass index （BMI） after 10 hours of o- vernight fasting. The characteristics of fasting glucose distribution and the influence of TG and BMI on ser- um fasting glucose in NAFLD patients were analyzed. Results The serum glucose, TG, BMI, and ALT were increased significantly in the NAFLD group compared with control group （P〈0. 01）. The number of patients with FPG〈5.6 mmol/L in the NAFLD group was significantly less than in the control group, and the IFG and number of diabetic patients were significantly more than in the control group （P〈0.01）. The level of blood glucose of the obese NAFLD patients with increased TG was significantly higher than that of control group （P〈0. 01）. Conclusions The detectable rate of abnormal FPG in the NAFLD group is significantly higher than in the control group. Hypertriglyceridemia and obesity worsen the impaired fasting glucose in the NAFLD patients.