2型糖尿病合并非酒精性脂肪肝临床分析

Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes

目的分析非酒精性脂肪肝(NAFLD)与2型糖尿病(T2DM)患者临床指标及血管病变的关系。方法选取住院T2DM患者214例,根据肝脏B超结果分为NAFLD组(合并NAFLD,n=116)和非NAFLD组(未合并NAFLD,n=98),回顾性分析2组患者的临床指标和血管病变发生情况。结果 NAFLD组较非NAFLD组体质指数(BMI),收缩压(SBP)、舒张压(DBP),血三酰甘油(TG)、γ-谷氨酰转移酶(GGT)、丙氨酸氨基转移酶(ALT)显著增高(P<0.05或P<0.01);Logistic多元回归分析显示SBP、TG、GGT是NAFLD的独立危险因素(P<0.05或P<0.01);NAFLD组大血管和微血管病变发生率显著高于非NAFLD组(P<0.05或P<0.01)。结论合并NAFLD的T2DM患者有明显的代谢综合征表现及肝酶升高,且糖尿病大血管和微血管病变发生率明显升高。

Objective To analyze the relationship of nonalcoholic fatty liver disease（NAFLD） to clinical parameters and vascular lesion in patients with type 2 diabetes mellitus（T2DM）.Methods According to the results of ultrasound examination,214 hospitalized patients with T2DM were divided into NAFLD group（n=116） and non-NAFLD group（n=98）.Clinical parameters and vascular lesion of patients were analyzed retrospectively.Results Compared with non-NAFLD group,NAFLD significantly increased body mass index（BMI）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,levels of triglyceride（TG）,γ-glutamyltransferase（GGT）and alanine aminotransferase（ALT）,and incidence of macrovascular and microvascular disease（P0.05 or P0.01）.Logistic regression analysis showed that SBP,TG and GGT were the independent risk factors for NAFLD（P0.05 or P0.01）.Conclusion T2DM patients with NAFLD have obvious metabolic syndrome with elevated liver enzymes and macrovascular and microvascular complications.