2型糖尿病合并非酒精性脂肪肝患者颈动脉粥样硬化相关因素分析

Analysis of the related factors of carotid atherosclerosis in type 2 diabetes mellitus patients complicated with nonalcoholic fatty liver disease

目的：探讨2型糖尿病合并非酒精性脂肪肝患者颈动脉粥样硬化的相关因素，以进一步提高临床诊疗水平。方法将288例2型糖尿病合并非酒精性脂肪肝患者，按照是否有颈动脉粥样硬化分为有颈动脉粥样硬化组（ A组）和无颈动脉粥样硬化组（ B组），对两组患者进行BMI、血压、血糖、血脂、肝功能等相关因素分析。结果两组患者的收缩压、舒张压差异无统计学意义（P＞0．05），有颈动脉粥样硬化组患者ALT（55．12±9．13）mmol／L、BMI（28．48±4．69）kg／m2、HbA1c（8．57±1．69）mmol／L、FPG（9．36±2．24）mmol／L、TG（2．12±0．38）mmol／L、TC（5．56±1．25）mmol／L、AST（25．34±5．23）mmol／L，显著高于无颈动脉粥样硬化组[（36．22±8．76）mmol／L、（23．96±3．73）kg／m2、（7．62±1．28）mmol／L、（8．67±1．98）mmol／L、（1．23±0.17）mmol／L、（4．31±1．09）mmol／L、（21．19±4．71）mmol／L（t＝17．564、8．726、5．163、2．694、8．788、6．894，均P＜0．01）]。多元逐步回归分析结果显示ALT与BMI存在显著的正相关（r＝0．132，P＜0．01），与AST呈显著负相关（r＝-0．091，P＜0．01）。结论 ALT水平的高低可以作为2型糖尿病合并非酒精性脂肪肝患者是否有颈动脉粥样硬化的风险指标，对患者的治疗和预后起到有效的促进作用，值得临床借鉴应用。

Objective To analyze the related factors of carotid atherosclerosis in type 2 diabetes mellitus pa-tients complicated with nonalcoholic fatty liver disease .Methods 288 type 2 diabetes mellitus patients complicated with nonalcoholic fatty liver disease were divided into carotid atherosclerosis group （group A） and non-carotid athero-sclerosis group （ group B ） , according to whether they had carotid atherosclerosis .The related factors of these two groups,such as BMI,blood pressure,blood glucose,blood lipid,liver function were analyzed.Results The two groups had no significant differences in systolic pressure and diastolic pressure （P〉0.05）.ALT,BMI,HbA1c,FPG,TG,TC, AST of group A were significantly higher than group B [ALT （55.12 ±9.13）mmol/L vs （36.22 ±8.76）mmol/L, BMI （28.48 ±4.69）kg/m2 vs （23.96 ±3.73）kg/m2,HbA1c （8.57 ±1.69）mmol/L vs （7.62 ±1.28）mmol/L, FPG （9.36 ±2.24）mmol/L vs （8.67 ±1.98）mmol/L,TG （2.12 ±0.38）mmol/L vs （1.23 ±0.17）mmol/L,TC （5.56 ±1.25）mmol/L vs （4.31 ±1.09）mmol/L,AST （25.34 ±5.23）mmol/L vs （21.19 ±4.71）mmol/L]（t=17.564,8.726,5.163,2.694,8.788,6.894,all P〈0.01）.The multiple stepwise regression analysis showed that there was a positive correlation between ALT and BMI （r=0.132,P〈0.01）,a negative correlation between ALT and AST（r=-0.091,P〈0.01）.Conclusion The level of ALT could be used as a risk index to judge whether the type 2 diabetes mellitus patients complicated with nonalcoholic fatty liver disease had carotid atherosclerosis .