苏北地区慢性丙型肝炎合并2型糖尿病患者临床特征分析

Clinical characteristics of chronic hepatitis C complicated with type 2 diabetes mellitus in Northern Jiangsu Province

目的探讨苏北地区慢性丙型肝炎（CHC）合并2型糖尿病（T2DM）患者的临床基本特征。方法根据是否合并T2DM将661例CHC患者分为CHC＋T2DM组（192例）和CHC组（469例），比较两组患者的临床资料及实验室检查结果，并分析其胰岛素抵抗指数（HOMA—IR）与肝脏病变程度的相关性。结果661例CHC患者的T2DM发病率为29．0％；CHC＋T2DM组年龄、有糖尿病家族史患者比例、甘油三酯（TG）、空腹胰岛素（FINS）、HOMA—IR、基因1b型患者比例及肝脏病变程度均明显高于CHC组（P〈0．05），而HDL-C水平明显低于CHC组（P〈0．05）；CHC＋T2DM组基线HOMA—IR水平与肝脏病变程度呈正相关（r=0．647，P〈0．001），而CHC组基线HOMA-1R水平与肝脏病变程度无相关性（r=0．173，P=0．129）。结论CHC与T2DM的发生密切相关；高龄、有糖尿病家族史、脂代谢异常、高胰岛素抵抗、感染基因lb型及肝脏病变程度重等为苏北地区CHC合并T2DM患者的基本临床特征。

Objective To investigate the clinical characteristics of patients with chronic hepatitis C（CHC） complicated with type 2 diabetes mellitus （ T2DM ） in Northern Jiangsu Province. Methods According to whether combined T2DM, 661 CHC patients were divided into CHC ＋ T2DM group （ 192 cases） and CHC group （469 cases）. The clinical data and laboratory examination results of all patients were compared. The correlation of homeostasis model assessment of insulin resistance （HOMA-IR） and severity of liver disease was analyzed. Results The prevalence of T2DM in the CHC patients was 29.0%. Age,ratios of patients with family history, serum levels of triglyceride （TG） ,fasting insulin （FINS）,HOMA-IR, ratios of patients with gene lb and liver disease severity in CHC ＋ T2DM group were significantly higher than those in CHC group （ P 〈 0. 05 ）, while serum high-density lipoproteincholesterol （ HDL-C ） was significantly lower than that in CHC group（P 〈0.05 ）. Baseline HOMA-IR levels in CHC ＋ T2DM group were positively correlated with the degree of liver disease （ r = 0. 647, P 〈 0. 001 ）, whereas baseline HOMA-IR levels were not correlated with the degree of liver disease in CHC group （r=0. 173, P = 0. 129 ）. Conclusion CHC is closely related with the occurrence of T2DM. Advanced age, having family history of diabetes, abnormal lipid metabolism, high insulin resistance, infection of type I b genes and severe liver disease are the basic clinical features of CHC combined with T2DM in Northern Jiangsu Province.