非酒精性脂肪性肝病及血清维生素D对2型糖尿病的影响

Effect of nonalcoholic fatty liver disease and serum vitamin D on type 2 diabetes

目的:探讨非酒精性脂肪性肝病对2型糖尿病的影响及血清维生素D在糖尿病合并非酒精性脂肪性肝病的作用。方法:收集2015年5月至2016年4月门诊及住院诊断的361例2型糖尿病患者,分为2型糖尿病合并非酒精性脂肪性肝病组(观察组)与2型糖尿病未合并非酒精性脂肪性肝病组(对照组),比较两组患者的生化指标,并分析观察组中维生素D与并发症发生的关系。结果:观察组患者的病程、体重指数、糖化血红蛋白、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、谷丙转氨酶、谷草转氨酶、胱抑素C、a羟丁酸脱氢酶水平与对照组相比,差异有统计学意义(P<0.05);观察组中维生素D严重缺乏组冠心病、视网膜病发生率高于缺乏组(P<0.05)。结论:非酒精性脂肪性肝病影响糖尿病患者血糖、血脂代谢;2型糖尿病合并非酒精性脂肪性肝病时,血清维生素D水平越低,冠心病、糖尿病视网膜病发生率越高。

Objective ：To investigate the effect of nonalcoholic fatty liver disease on type 2 diabetes and the effect of serum vitamin D on nonalcoholic fatty liver disease in diabetic patients. Methods：361 cases of patients with type 2 diabetes from May 2015 to April 2016 were collected and divided into type 2 diabetes with nonalcoholic fatty liver disease Group （observation Group） and type 2 diabetes without nonalcoholic fatty liver disease Group （control group）. The biochemical indexes were compared in the two groups, and the relationship between vitamin D and complication in the observation group was analyzed. Results： Compared with the control group, the disease course, body mass index, glycosylated hemoglobin, cholesterol, triglyceride, high - density lipoprotein, low - density lipoprotein, alanine transaminase, straw transaminase, cystatin C and a hydroxy butyrate de- hydrogenase level in the observation group were statistically significant （ P 〈 0.05 ） ; In the observation group, the incidence of coronary heart disease and retinal disease in the patients with severe vitamin D deficiency was higher than that in the patients lack of vitamin D （ P 〈 0.05 ）. Conclusions ： Nonalcoholic fatty liver disease affects blood glucose and lipid metabolism in patients with diabetes ; The lower the level of serum vitamin D in type 2 diabetes with nonalcoholic fatty liver disease is, the higher the incidence of coronary heart disease and diabetic retinopathy will be.