新诊断2型糖尿病患者血钾水平与非酒精性脂肪性肝病的相关性研究

Association between serum potassium and non-alcoholic fatty liver disease in newly diagnosed type 2 diabetes mellitus

目的探讨新诊断T2DM患者血钾(K^+)水平与非酒精性脂肪性肝病(NAFLD)的关系。方法选取2015年6月至2017年3月于我院内分泌科住院治疗的265例新诊断T2DM患者,根据肝脏彩色超声结果分为T2DM组(n=121),T2DM合并NAFLD组(NAFLD,n=144),按照血K^+水平三分位数将新诊断T2DM患者分为<4.13mmol/L组、4.13～4.53mmol/L组及>4.53mmol/L组。行肝脏彩色超声检查及血脂、胰岛素、血K^+等相关指标的测定。结果 NAFLD组BMI、WC、TG、FFA、γ-谷氨酰基转移酶(γGGT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、胰岛素抵抗指数(HOMA-IR)均高于T2DM组,而血K^+水平低于T2DM组(P<0.05或P<0.01);血K^+水平与年龄、SBP、BMI、WC、ALT、γGGT、HOMA-IR呈负相关(r=-0.145、-0.163、-0.289、-0.328、-0.161、-0.194、-0.336,P<0.05)。Logistic回归分析显示,校正BMI、WC、HOMA-IR后,血K^+水平仍与NAFLD相关[OR=0.418,95%CI0.343～0.658),P=0.002]。随着血K^+水平的升高,NAFLD患病率逐渐下降(75.26%vs 67.05%vs19.54%,P<0.05)。结论 T2DM患者血K^+水平与NAFLD密切相关,可能为T2DM患者合并NAFLD的治疗提供新思路。

Objective To explore the association between serum potassium and non-alcoholic fatty liver disease in newly diagnosed type 2 diabetes（T2DM）. Methods A total of 265 subjects with newly diagnosed T2DM were divided into two groups according to hepatic ultrasonography results：patients with NAFLD（NAFLD,n=144）and patients without NAFLD（T2DM,n=121）.All subjects were subdivided into three groups according to tertiles of serum potassium levels（4.13 mmol/L group,4.13～4.53 mmol/L group and4.53 mmol/L group）.Clinical characteristics,serum potassium,lipids and insulin were measured in all the subjects. Results BMI,waist circumference（WC）,TG,FFA,ALT,γGGT,AST and HOMA-IR were all higher,while serum potassium levels were lower in NAFLD group than in T2DM group（P〈0.05）.Serum potassium level was negatively correlated with age,systolic blood pressure（SBP）,BMI,WC,ALT,γGGT and HOMA-IR（r=-0.145,-0.163,-0.289,-0.328,-0.161,-0.194,-0.336,P〈0.05）.Logistic regression analysis showed that after adjustment of BMI,WC,HOMA-IR,serum potassium level was still correlated with NAFLD [OR=0.418,95% CI0.343～0.658],P=0.002].The prevalence of NAFLD was decreased by the elevation of serum potassium levels（75.26% vs67.05%vs 19.54%,P〈0.05）. Conclusion In T2DM,serum potassium levels were significantly correlated with NAFLD,which may provide a new treatment strategy for T2DM with NAFLD.