2型糖尿病患者肝损害的危险因素分析

Risk factors of hepatic dysfunction in patients with type 2 diabetes mellitus

目的 探讨2型糖尿病（T2DM）患者肝损害的危险因素.方法 回顾性分析39例T2DM性肝损害患者和59例单纯糖尿病患者的临床资料及并发症情况并进行比较,采用多因素Logistic回归分析筛选T2DM患者肝损害的危险因素.结果 两组患者糖化血红蛋白（HbA1c）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、AST、ALT、γ-谷氨酰转肽酶（γ-GT）、碱性磷酸酶（ALP）、白蛋白（Alb）、球蛋白（Glb）、尿酸、胰岛β细胞功能指数（HOMA-BI）比较,差异均有统计学意义（P＜0.05）.多因素Logistic回归分析结果显示,HbA1c为T2DM患者肝损害的独立危险因素（OR=1.311,95％CI1.005～1.710,P=0.046）.两组患者糖尿病酮症酸中毒（DKA）发生率比较差异有统计学意义（P =0.037）.结论 血糖、血脂、血尿酸和T2DM患者肝损害的发生有关,HbA1c为T2DM患者肝损害的独立危险因素.

Objective To explore risk factors of hepatic dysfunction in patients with type 2 diabetes mellitus（T2DM）.Methods Clinical data and complications of 39 cases of T2DM with hepatic dysfunction and 59 cases of simple T2DM were retrospectively analyzed and compared.Multivariate Logistic regression analysis was performed on the risk factors of hepatic dysfunction.Results Glycosylated hemoglobin A 1 （HbA1c）,total cholesterol （TC）,low density lipoprotein cholesterol （LDL-C）,AST,ALT,γ-glutamyl transpeptidase （γ-GT）,alkaline phosphatase （ALP）,albumin （Alb）,globulin （Glb）,uric acid and islet beta cell function index （HOMA-BI） in two groups were statistically different （P 〈 0.05）.Multivariate Logistic regression analysis showed that HbA1c was the independent risk factor of hepatic dysfunction in patients with T2DM （OR =1.311,95 % CI 1.005-1.710,P =0.046）.When we compared complications between the two groups,there was significant difference in the occurrence of diabetic ketoacidosis （P =0.037）.Conclusion Blood glucose,blood fat and uric acid are related to the occurrence of hepatic dysfunction in T2DM patiens.HbA1c was an independent risk factor of hepatic dysfunction in patients with T2DM.