2型糖尿病患者非酒精性脂肪肝检出率及危险因素分析

POSITIVE RATE OF NONALCOHOLIC FATTY LIVER IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ITS RISK FACTORS

目的了解2型糖尿病(T2DM)患者合并非酒精性脂肪性肝病(NAFLD)患病率及相关危险因素。方法选取2013年1月—2015年2月住院T2DM患者137例为研究对象,采用临床对照研究,根据有无合并NAFLD分为观察组(T2DM合并NAFLD组)101例,对照组(单纯T2DM组)36例。观察二组患者的病史及既往病史、吸烟史、饮酒史、性别、年龄、血压、身高、体重、体重指数(BMI)、血糖、血脂、谷丙转氨酶、谷草转氨酶、肾功能及胰岛素抵抗指数(TYG)等指标,比较二组与代谢综合征及其各组分的相互关系。结果 1住院T2DM患者NAFLD检出率73.72%,男为82.67%、女为62.90%,性别有差异有统计学意义;2合并NAFLD组的BMI、甘油三酯、谷丙转氨酶、谷草转氨酶及TYG高于单纯T2DM,差异有统计学意义;多因素Logistic回归分析男性、BMI、空腹血糖及TYG是T2DM合并NAFLD的危险因素;3合并NAFLD组比较单纯T2DM组超重/肥胖及血脂紊乱差异有显著统计学意义,随着代谢因素增加,代谢综合征检出率成倍上升,二组间高血压病有明显的重叠性。结论重视T2DM与NAFLD共存不良结局,积极控制T2DM的体重指数、血糖及甘油三酯,减少NAFLD发生、发展。

Objective To understand the prevalence of type 2 diabetes mellitus（T2DM）patients complicated with nonalcoholic fatty liver disease（NAFLD）and its related risk factors.Methods From January2013 to February 2015,137 cases of hospitalized T2 DM patients were selected as the research subjects,they were divided into experimental group（nonalcoholic fatty liver with type 2 diabetes mellitus,101 cases）,the control group（simple type 2 diabetes mellitus,36 cases）according to the presence or absence of complicated with NAFLD.The related factors were observed and compared between the two groups included history and past medical history,smoking history,drinking history,gender,age,blood pressure,height,weight,body mass index（BMI）,blood glucose,blood lipid,alanine aminotransferase,aspartate aminotransferase,renal function and insulin resistance index.Results The positive rate of NAFLD in patients with T2 DM was 73.72%,male 82.67%,female 62.90%,the difference in gender was obviously;In combined with NAFLD group,the BMI,triglyceride,ALT,AST and TYG were higher than that in pure T2 DM,the differences were statistically significant.Multivariate logistic regression analysis showed that male,BMI,fasting blood glucose and TYG were the risk factors of T2 DM combined with NAFLD;Combined with NAFLD group compared to T2 DM alone group in overweight/obesity and dyslipidemia were significant differences,the prevalence of metabolic syndrome was doubled with the increase of metabolic factors,and hypertensive patients were significant overlap in two groups.Conclusion We should pay more attention to the importance of adverse outcomes T2 DM and NAFLD coexistence.To control BMI,Blood glucose and triglyceride for patients with T2 DM can reduce the nonalcoholic fatty liver.