新诊断2型糖尿病合并非酒精性脂肪肝胰岛素抵抗和胰岛β细胞功能特点分析

Insulin resistance and islet beta cell function in newly diagnosed type 2 diabetic patients with nonalcoholic fatty liver disease

目的探讨新诊断2型糖尿病合并非酒精性脂肪肝(NAFLD)患者胰岛素抵抗和胰岛β细胞功能特点,为临床用药的选择提供参考。方法将120例新诊断2型糖尿病患者按有无合并NAFLD分为NAFLD组(80例)与无NAFLD组(40例)。记录、检测或计算两组的身高、BMI、血压、血糖、血脂、尿酸、肝酶等代谢指标以及胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能(HOMA-β),并对两组结果进行比较。结果 NAFLD组患者的空腹血糖、GHbA1c、ALT、GGT、尿酸、甘油三酯及LDL-C、空腹胰岛素、空腹C肽水平及HOMA-IR均高于无NAFLD组(P<0.05),HLDLC、HOMA-β则低于无NAFLD组(P均<0.05)。结论与无合并NAFLD者比较,新诊断2型糖尿病合并NAFLD者高血糖、高尿酸、脂质代谢异常及肝酶升高等代谢紊乱情况更严重,且胰岛素抵抗及胰岛β细胞分泌功能受损更明显。

Objective To investigate insulin resistance and islet beta cell function in newly diagnosed type 2 diabetic patients with nonalcoholic fatty liver disease. Methods One hundred and twenty patients with newly diagnosed type 2 diabetes mellitus were recruited and divided into NAFLD group （ n = 80 ） and non- NAFLD group （ n = 40 ）. Metabolic indexes were measured and recorded. HOMA insulin resistance index （HOMA-IR） was used to assess insulin resistance and HOMA-β was used to evaluate islet beta cell function. Results Compared with non-NAFLD group, fasting blood glucose, GHbA1c, ALT, gamma-glutamyl transferase （GGT）, uric acid, triglyceride, LDL-C, fasting insulin, fasting C and HOMA-IR were significantly higher in NAFLD group （ P 〈 0.05 ）, while HOMA-β was lower （ P 〈 0. 05 ）. Conclusion Compared to non-NAFLD group, patients with newly diagnosed type 2 diabetes in NAFLD group demonstrate more metabolic disorders, severer insulin resistance and more damage of islet beta cell function.