糖尿病非肥胖人群腰围与新发非酒精性脂肪肝的关系

The relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus

目的探讨糖尿病非肥胖人群腰围增加与新发非酒精性脂肪肝之间的关系。方法采用前瞻性队列研究方法,选取空腹血糖≥7.0 mmo L/L或<7.0 mmo L/L但既往已被确诊为糖尿病并使用降糖药物且体质指数(BMI)<25 kg/m2者1 950例,依据基线腰围分为5组,腰围<78 cm为A组(387例);78 cm≤腰围<82 cm为B组(377例);82 cm≤腰围<85 cm为C组(307例);85 cm≤腰围<90 cm为D组(458例);腰围≥90 cm为E组(421例)。应用多重Logistic回归模型分析影响糖尿病非肥胖人群新发脂肪肝的影响因素。结果观察队列的平均随访时间为(47.24±5.13)个月,至2010年度查体时,非酒精性脂肪肝的发病率为11.85%(231/1 950),A、B、C、D、E组发病率依次为6.98%、9.28%、12.38%、14.19%、15.68%,其随腰围水平的增加而依次升高(P<0.05)。在多重Logistic回归模型分析中,与A组比较,总人群D、E组的OR值分别为1.97、2.19(P<0.05)。结论糖尿病非肥胖人群腰围≥85 cm是新发非酒精性脂肪肝的危险因素。

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose（FPG）≥7.0 mmol/L or who were using hypoglycemic drugs and FPG〈7.0 mmol/L,and body mass index （BMI）〈 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference〈78 cm （A group, n=387）, 78 cm〈waist circumference〈82 cm （B group, n=377, 82 cm〈waist circumference〈85 cm （C group, n=307, 85 cm〈waist circum？ference〈90 cm （D group, n=458, waist circumference〉90 cm （E group, n=421）. Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re？sults The average duration of follow-up was（47.24±5.13） months. The incidence rate was 11.85%（231/1 950） in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference （P〈0.05）. Results of multiple Logistic re？gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively （P〈0.05）. Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.