优化性健康行为干预对2型糖尿病合并非酒精性脂肪肝患者胰岛素抵抗指数和脂肪肝指数的影响

Effect of optimized healthy behavior intervention on insulin resistance index and fatty liver index in patients with type 2 diabetes and nonalcoholic fatty liver disease

目的探讨优化性健康行为干预对2型糖尿病合并非酒精性脂肪肝(NAFLD)患者胰岛素抵抗指数(HOMA-IR)和脂肪肝指数(FLI)等的影响。方法选取2016年1-12月漯河市某医院诊治的98例2型糖尿病合并NAFLD患者为研究对象。采用随机数字表法将患者分为对照组和研究组,每组49例。给予对照组患者普通健康行为干预。给予研究组患者优化性健康行为干预。干预12周时,比较2组患者的干预效果;比较2组患者干预前后空腹血糖(FBG)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)水平;比较2组患者干预前及干预后HOMA-IR和FLI。结果研究组患者治疗总有效率为89.8%,高于对照组的65.3%,差异有统计学意义(χ2=8.44,P<0.05)。干预前,2组患者FBG,ALT,AST,TC,TG及LDL-C水平比较,差异无统计学意义(P>0.05);干预后,2组患者FBG,ALT,AST,TC,TG及LDL-C水平均低于干预前,且研究组患者低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者HOMA-IR及FLI比较,差异无统计学意义(P>0.05)。干预后,2组患者HOMA-IR及FLI均小于干预前,且研究组小于对照组,差异均有统计学意义(P<0.05)。结论采用优化性健康行为干预可提高2型糖尿病合并NAFLD患者的治疗效果,改善血脂及肝酶学等指标,并降低HOMA-IR和FLI,效果显著,值得临床推广应用。

Objective To investigate the effect of optimized healthy behavior intervention on insulin resistance in dex （HOMA IR） and fatty liver index （FIA） in patients with type 2 diabetes and nonalcoholic fatty liver disease （NAFLI））. Methods A total of 98 patients with type 2 diabetes and NAFLD treated at a Luohc hospital between January 2016 and I）cccmbcr 2016 were included in this study. Based on a random number table, patients were al located to receive optimized healthy behavior intervention （trial group, n=49） or conventional healthy behavior intervention （control group, n=49）. The fasting blood glucose （FBG） , alaninc aminotransfcrasc （ALT） , aspartate aminotransferase （AST）, total cholesterol （TC）, triglyceride （TG） , and low density lipoprotein （LDL-C） ; as well as HOMA IR and FLI were determined at baseline and 12 weeks after intervention. The intervention ef fcctivcncss was compared between the two groups. Results The overall response rate was significantly higher in the trial group compared with that in the control group （89.8% versus 65.3%, x2 =8.44, P〈0.05）. Before in tcrvcntion, the FBG, ALT, AST, TC, TG and LDL-C levels were comparable between the two groups （P〉 0.05）; after intervention, all of these levels were reduced in both groups, with greater reductions in the trial group （P〈0.05）. Before intervention, the HOMA ]R and FL] were similar between the two groups （P〉0.05） ; after intervention, they were reduced in both groups, with greater reductions in the trial group （P〈0.05）. Conclusion For patients with typc 2 diabetes and NAFLD, optimized healthy behavior intervention may enhance treatment response, improve blood lipid and liver enzyme values, reduce HOMA IR and FLI, and thus deserves widespread clinical application.