幽门螺杆菌感染与2型糖尿病性脂肪肝的关系

Relationship between Helicobacter pylori infection and type 2 diabetic fatty liver

目的:探讨幽门螺杆菌(Helicobacter pylori,H.pylori)感染与糖尿病性脂肪肝的关系,为临床诊治提供依据.方法:131例2型糖尿病患者行胃黏膜组织切片染色确定H.pylori感染,分为H.pylori阳性组62例,H.pylori阴性组69例,行腹部彩超检查和血脂、血清C肽、空腹血糖、空腹胰岛素,并计算胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMR-IR)及体质量指数(body mass index,BMI).结果:H.pylori阳性组的糖尿病性脂肪肝发生率71.0%(44/62),H.pylori阴性组糖尿病性脂肪肝发生率50.7%(35/69),差异有统计学意义(P<0.05);H.pylori阳性组甘油三酯、HOMR-IR均明显高于H.pylori阴性组,血清C肽低于H.pylori阴性组,差异均有统计学意义(P<0.05),而胆固醇及低密度脂蛋白(lowdensity lipoprotein,LDL)、高密度脂蛋白(high-density lipoprotein,HDL)、BMI在两组间均无统计学差异(P>0.05).结论:糖尿病性脂肪肝患者中H.pylori感染率高,高H.pylori感染加重糖尿病性糖脂代谢紊乱及胰岛素抵抗,加重脂肪肝进展,或许积极抗H.pylori治疗,有利于缓解或减少糖尿病性脂肪肝的发生、发展.

AIM： To investigate the relationship between Helicobacter pylori （H. pylori） infection and diabetic fatty liver. METHODS： One hundred and thirty-one patients with type 2 diabetes who underwent gastric mucosa biopsy staining to determine H. pylori infection were divided into an H. pylori positive group （n = 62） and an H. pylori negative group （n = 69）. All patients underwent abdominal color Doppler examination. Blood lipids, serum c-peptide, fasting glucose, serum insulin, homeostasis model assessment for insulin resistance （HOMR-IR）, and body mass index （BMI） were also measured. RESULTS： In the H. pylori positive group, the detection rate of diabetic fatty liver was 71.0% （44/62）, which was significantly higher than that in the H. pylori negative group [50.7% （35/69）; P 〈 0.05]. In the H. pylori positive group, triglycerides and HOMR-IR were significantly higher, but serum c-peptide was significantly lower than those in the H. pylori negative group （P 〈 0.05）. Cholesterol, low-density lipoprotein （LDL）, high-density lipoprotein （HDL）, and BMI had no significant differences between the two groups. CONCLUSION： In patients with diabetic fatty liver, H. pylori infection rate is higher. H. pylori infection aggravates sugar-lipid metabolic disorder and increases insulin resistance and fatty liver in diabetics. Anti-H.pylori treatment may alleviate or reduce the occurrence and development of diabetic fatty liver.