2型糖尿病患者合并非酒精性脂肪肝的临床特征及合并症分析

Analysis of the clinical features and complications of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

目的探讨住院2型糖尿病(T2DM)非酒精性脂肪肝(NAFLD)的患病率、临床特征、合并症情况及相关危险因素。方法收集226名T2DM住院患者的临床、肝脏彩超及生化指标检查资料,统计NAFLD的患病率,并分析其临床特征及合并症情况。结果住院T2DM患者中B超诊断NAFLD为82例(36.2%),其中26例合并一种或一种以上的血清肝酶升高(31.7%)。男性NAFLD的患病率为39.3%,女性NAFLD的患病率为33.6%,男性患病率明显高于女性(P<0.05)。合并NAFLD组患者的体重指数、腰围、臀围、腰臀比、空腹胰岛素、餐后2小时胰岛素、甘油三酯、尿酸、舒张压高于无NAFLD组,高密度脂蛋白胆固醇低于无NAFLD组(P<0.05),NAFLD组患者合并代谢综合征、高血压、糖尿病周围神经病变、糖尿病肾病,糖尿病大血管病变的比例也明显高于无NAFLD组。结论住院T2DM患者中NAFLD患病率高,且男性患病率高于女性。T2DM合并非酒精性脂肪肝的患者合并症更高发。

Objective To explore the prevalence, clinical features, complications and relative factors of non-alcoholic fatty liv- er diseases （NAFLD） in inpatients with type 2 diabetes mellitus （T2DM）. Methods The data of clinical examinations, liver ultra- sound examination and biochemical tests of 226 inpatients with T2DM were retrieved to analyze the prevalence of NAFLD, clinical fea- tures and complications. Results In the 226 patients, there were 82 suffering NAFLD （36. 2% ）. Of the 82 patients, 26 had one or more than one elevated liver enzymes （31.7%）. The prevalence of NAFLD in male patients was higher than that in female patients （39.3% vs. 33.6% ）. The parameters such as BMI,waist circumference,hip circumference,WHR,FINS,PINS,TG,uric acid and DBP in the patients with NAFLD were higher but HDL-C was lower than those in the patients without NAFLD （ P 〈 0. 05 ）. Moreover, the in- cidence of complications such as metabolic syndrome, hypertension, diabetic neuropathy, diabetic nephropathy and diabetic vascular complications in the patients with NAFLD were higher than that in the patients without NAFLD. Conclusion Inpatients with T2DM have a higher prevalence of NAFLD in which the prevalence in male patients is higher than that in the female patients. T2DM patients with NAFLD have a higher incidence of complications.