2型糖尿病合并非酒精性脂肪肝的临床特点及危险因素分析

Clinical characters and risk factors of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的临床特点及其相关危险因素。方法随机抽取我院已建立健康档案的糖尿病患者200例,根据是否合并非酒精性脂肪肝分为两组,比较T2DM合并NAFLD(A组,n=114)与T2DM不合并NAFLD(B组,n=86)患者之间的临床特征,探讨影响NAFLD的危险因素。结果两组患者体重指数(BMI)、腰围(WC)、舒张压(DBP)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA)、血清丙氨酸转氨酶(ALT)、空腹血糖(FBG)水平比较差异有统计学意义(P<0.01或P<0.05);A组代谢综合征、肥胖症、脂代谢紊乱、冠心病、高血压病的发生率明显高于B组(P<0.01或P<0.05)。Logistic回归分析显示BMI、TG、UA对糖尿病合并NAFLD的发生有显著影响(均P<0.01)。结论 2型糖尿病合并NAFLD易发生于肥胖、血脂紊乱、胰岛素抵抗人群,2型糖尿病患者的BMI、TG、UA升高是并发非酒精性脂肪性肝病的危险因素。

Objective To investigate clinical characters and risk factors of non-alcoholic fatty liver disease （NAFLD） in patients with type 2 diabetes mellitus （T2DM）. Methods According to whether the patients had NAFLD, 200 patients with T2DM consistent with the standard were divided into fatty liver group （group A, n=114） and non-fatty liver group （group B, n=86）. The clinical characters of group A was compared to those of group B. The risk factors about NAFLD were analyzed by Logistic regression. Results The levels of body mass index （BMI）, waist circumference （WC）, diastolic blood pressure （DBP）, serum triglyceride （TG）, blood uric acid （UA）, alanine ami-notransferase （ALT）, low density lipoprotein cholesterol （LDL-C）, fasting plasma glucose （FPG） showed statistically significant difference between the two groups （P0.01 or P0.05）. Group A had significantly higher incidence of metallic syndrome, obesity, dyslipidemia, coronary heart disease and hypertension than group B. Logistic regression analysis showed that BMI, TG and UA were the risk factors of NAFLD （P0.01）. Conclusion NAFLD complicated with T2DM is prone to occur in people with obesity, dyslipidemia and IR. BMI, TG and UA are the risk factors of NAFLD