尿微量白蛋白及促甲状腺激素与2型糖尿病合并非乙醇性脂肪性肝病的相关性

Relationship between microalbuminuria,serum thyroid stimulating hormone and type 2 diabetes mellitus patients with nonalcoholic fatty liver disease

目的:探讨2型糖尿病(T2DM)患者的尿微量白蛋白及促甲状腺激素(TSH)与非乙醇性脂肪性肝病(NAFLD)发生的相关性。方法:收集T2DM患者254例,分为T2DM组124例和T2DM合并NAFLD组130例,检测所有受试者的一般临床资料、血液指标及尿微量白蛋白,应用SPSS 16.0软件进行统计分析。结果:两组患者年龄、病程、身高、收缩压、舒张压、LDL-c、HDL-c、红细胞、白细胞、血小板、HbA1c间的差异均无统计学意义(均P>0.05)。而体质量、BMI、腰臀比、三酰甘油、总胆固醇、ALT、AST、尿微量白蛋白、TSH、胰岛素抵抗指数(HOMA-IR)组间差异均有统计学意义(P<0.05)。单因素Logistic回归分析结果显示,体质量、BMI、腰臀比、总胆固醇、三酰甘油、尿微量白蛋白、TSH与NAFLD有相关性;多因素Logistic回归分析显示,TSH、BMI、腰臀比、尿微量白蛋白为NAFLD的主要相关因素。结论:在T2DM患者中,尿微量白蛋白、TSH、BMI、腰臀比是NAFLD发生的独立相关因素。

Objective： To explore the relationship between microalbuminuria, serum thyroid stimula- ting hormone （TSH） level and type 2 diabetic patients （T2DM） with nonalcoholic fatty liver disease （NAFLD）. Methods： A total of 254 T2DM patients were divided into the T2DM group （type 2 diabetic patients without NAFLD, n = 124） and the NAFLD group （T2DM patients with NAFLD, n = 130）. All the subjects＇ general clinical data and hematological parameters were collected, SPSS 16.0 software were used for statistical analysis. Results： Age, disease course, height, SBP, DBP,LDL-c, HDL-c, RBC, WBC, PLT and HbA1 c had no statistical significance between two groups （P 〉 0.05 ）. The body weight, body mass index（BMI）, WHR,triglyceride, total cholesterol, ALT, AST, microalbuminuria, TSH, and HOMA-IR had a statistically significant difference between two groups （ P 〈 0.05 ）. With NAFLD as the dependent variable, univariate Logistic regression results showed that the body weight, BMI, WHR, total cholesterol, triglyceride, microalbuminuria, TSH were associated with NAFLD; Multivariate Logistic re- gression results showed that TSH, BMI, WHR, microalbuminuria were the independent influencing factor for NAFLD. Conclusion： In patients with T2DM, microalbuminuria, TSH, BMI, WHR were the independent influencing factors for NAFLD.