老年2型糖尿病合并非酒精性脂肪肝患者的危险因素分析

Related risk factors of elderly patients with type 2 diabetes mellitus combined with non-alcoholic fatty liver disease

目的研究老年2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者的临床特征及胰岛素抵抗(IR)水平,并探讨其主要危险因素。方法回顾分析老年T2DM患者112例,其中非NAFLD组50例,合并NAFLD组62例。比较两组之间的体质量指数(BMI)、腰臀比(WHR)、血脂、肝酶及胰岛素抵抗等指标,并采用Logistic回归分析T2DM患者合并NAFLD的危险因素。结果 NAFLD组BMI、WHR、三酰甘油(TG)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、胰岛素抵抗指数(HOMA-IR)较非NAFLD组均显著升高。Logistic多元回归分析显示WHR、TG、HOMA-IR是T2DM合并NAFLD患者的危险因素,而HOMA-IR为主要危险因素。结论老年2型糖尿病合并非酒精性脂肪肝患者存在严重的代谢紊乱与胰岛素抵抗。

Objective To investigate the relationship between clinical feature,insulin resistance(IR) and nonalcoholic fatty liver disease( NAFLD) in elderly patients with T2 DM,and the risk factors of NAFLD. Methods A total of 112 in elderly patients with T2 DM were recruited in this study. they were divided into T2 DM without NAFLD groups(50 cases),T2 DM with NAFLD(62 cases). Some indexes including body mass index( BMI) and waist-hip ratios(WHR),blood fat,serum transaminase and insulin resistance index were measured and compared. The risk factors about NAFLD were analyzed by Logistic regression. Rusult BMI,WHR,TG,ALT,AST and HOMA-IR were significantly higher in NAFLD group than in non-NAFLD group. The Logistic regression analysis showed that WHR,TG and HOMA-IR were the independent factors of T2 DM with NAFLD group. Conclusion Elderly T2 DM patients with NAFLD have remarkable metabolic disorders and insulin resistance.