新诊断2型糖尿病患者中非酒精性脂肪肝与颈动脉内膜中层厚度的相关性分析

Analysis of the relationship of non-alcoholic fatty liver disease and intima-media thickness of carotid artery in patients with type 2 diabetes mellitus

目的探讨新诊断2型糖尿病(T2DM)患者中非酒精性脂肪肝(NAFLD)与颈动脉内膜中层厚度(IMT)的关系。方法选择新诊断的2型糖尿病患者142例,分为T2DM不合并NAFLD组(A组)79例和T2DM合并NAFLD组(B组)63例,所有受试者测量身高、体质量及血压,检测空腹血糖(FBG)、血脂、尿酸(UA)、糖化血红蛋白(HbA1c)、空腹血清胰岛素(FINS)水平,计算体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR),采用高分辨多普勒超声检测颈动脉内膜中层厚度,对2组进行相关的统计学比较和分析。结果 2组患者的年龄及血压比较无显著性差异,B组BMI、FINS、HOMA-IR、TG、LDL、UA及IMT明显高于A组,HDL低于A组。Person相关分析显示IMT与BMI、FINS、HOMA-IR、TG、LDL、UA呈明显正相关,多元线性逐步回归分析发现:IMT与BMI及HOMA-IR显著相关。结论新诊断T2DM合并NAFLD患者发生颈动脉硬化的风险要高,可能通过胰岛素抵抗介导所致。

Objectives It is to investigate the relationship of non-alcoholic fatty liver disease with intima-media thickness （IMT） of carotid artery in patients with type 2 diabetes mellitus（T2DM）. Methods 142 cases of patients with T2DM firstly di- agnosed were divided into two groups： with no non-alcoholic fatty liver disease（ group A, n = 79） and non-alcoholic fatty liver disease （group B, n = 63）. Body height, weight, blood pressure, fasting plasma glucose（FBG） , fasting insulin, triglyceride, total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, HbAlc were measured in both groups. Body mass index and insulin resistance index with homeostasis model were calculated. Patients in both groups accept- ed high-frequency Doppler echocardiography to elevate IMT of carotid artery. The differences in the indexes above were com- pared and analyzed between both groups. Results There was no significant differences in age and blood pressure between the two groups. BMI, FINS, HOMA - IR, TG, LDL, UA and IMT were significantly increased in B group compared with A group （P 〈 0.05）. Pearson correlation analyze indicated that IMT was positively correlate with BMI, FINS, HOMA -IR, TG, LDL, UA. Multiple stepwise regression analysis indicated that IMT were dependently correlated with BMI and HOMA -IR. Conclusion The patients with T2DM first diagnosed with non-alcoholic fatty liver disease have high danger of atherosclerosis attack and which may induced by insulin resistance.