住院2型糖尿病患者非酒精性脂肪性肝病与血镁水平的相关性分析

Association between nonalcoholic fatty liver disease and serum magnesium level in patients with type 2 diabetes mellitus

目的了解住院2型糖尿病患者非酒精性脂肪性肝病（NAFLD）与血镁水平的相关性。方法连续收集2013年6月至2017年6月北京大学人民医院内分泌科住院的1 273例2型糖尿病患者的临床资料。根据血镁水平四分位数分组，其中≤0.79 mmol/L者376例（Q1组），0.80～0.84 mmol/L者296例（Q2组），0.85～0.89 mmol/L者287例（Q3组），≥0.90 mmol/L者314例（Q4组）。采用logistic回归分析法分析NAFLD的患病和血镁水平的相关性。结果1 273例患者年龄为（56.4±13.8）岁，其中男性占52.7%（671/1 273），NAFLD患者占58.4%（743/1 273）。Q4～Q1组的NAFLD患病率分别为53.8%（169/314）、52.6%（151/287）、57.4%（170/296）和67.3%（253/376），差异有统计学意义（χ2＝19.00，P＝0.000）。调整年龄、性别、糖尿病病程、BMI、收缩压、饮酒、TG、糖化血红蛋白和血尿酸后，logistic回归分析显示，与Q4组相比，Q1组患NAFLD的OR（95%CI）为1.49（1.03～2.16），P趋势＝0.011。进一步调整估算的肾小球滤过率（eGFR）后与Q4组相比，Q1组患NAFLD的OR（95%CI）为1.33（0.92～1.94），P趋势＝0.065。结论血镁水平的降低与2型糖尿病患者NAFLD的患病风险增加相关，eGFR可能是混杂因素。

ObjectiveTo investigate the association between nonalcoholic fatty liver disease （NAFLD） and serum magnesium level in patients with type 2 diabetic mellitus （T2DM）.MethodsClinical data of 1 273 consecutive patients with T2DM admitted in hospital from June 2013 to June 2017 were retrospectively analyzed. According to the quartile of serum magnesium levels, patients were divided into 4 groups： Q1 group （≤ 0.79 mmol/L, n=376）, Q2 group （0.80-0.84 mmol/L, n=296）, Q3 group （0.85-0.89 mmol/L, n=287） , and Q4 group （≥0.90 mmol/L, n=314）. Logistic regression was used to analyze the association between NAFLD and serum magnesium level.ResultsThe average age of the study population was （56.4±13.8） years, males accounted for 52.7%（671/1 273）, NAFLD patients accounted for 58.4%（743/1 273）. The prevalence of NAFLD in Q4, Q3, Q2 and Q1 groups was 53.8%（169/314）, 52.6%（151/287）, 57.4%（170/296） and 67.3%（253/376）, respectively （χ2=19.00, P=0.000）. Logistic regression showed that compared with the Q4 group, OR（95%CI） for NAFLD in the Q1 group was 1.49 （1.03-2.16）, Ptrend=0.011 after adjusting for age, sex, duration of diabetes, BMI, systolic blood pressure, alcohol consumption, TG, glycosylated hemoglobin and serum uric acid. After further adjusting for estimated glomerular filtration rate （eGFR）, OR（95%CI） for NAFLD was 1.33 （0.92-1.94） and Ptrend=0.065 in the Q1 group compared with the Q4 group.ConclusionReduction in serum magnesium is associated with an increased risk of NAFLD in T2DM patients, and eGFR may be a confounding factor.