2型糖尿病患者胆囊切除手术与非酒精性脂肪性肝病的相关性研究

Correlation analysis between cholecystectomy and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

目的探讨T2DM患者胆囊切除手术与非酒精性脂肪性肝病(NAFLD)的关系。方法选取2011年1月至2014年12月于上海交通大学附属第六人民医院内分泌科住院治疗的T2DM患者3970例,根据是否行胆囊切除手术分为胆囊切除组(CC,n=535),胆囊未切除即对照组(Con,n=3435),比较两组一般临床资料和肝功能、肾功能、血脂、C-RP、HbA1c、糖化白蛋白(GA)、血常规等指标。结果CC组NAFLD患病率高于Con组(60.9%vs 46.1%,P<0.01),BMI、TG较Con组高(P<0.05)。二元Logistic回归分析结果显示,胆囊切除、性别、WC、TG及BMI与NAFLD独立相关(OR=1.508、1.373、1.046、2.056、1.178,P<0.01)。结论 T2DM患者中,胆囊切除与NAFLD的发病独立相关。

Objective To explore the relationship between nonalcoholic fatty liver disease （NAFLD） and cholecystectomy in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 3970 hospitalized patients with T2DM were enrolled in this study from Jan 2011 to Dec 2014 in the Endocrinology Department in The Sixth People＇s Hospital Affiliated to Shanghai Jiao Tong University.All the subjects were divided into two group：Without cholecystectomy group（Con,n=3435）and cholecystectomy group （CC,n=535）.Clinical data and biochemical indexes of the two groups were compared including liver function,renal function,blood lipid,C-RP,glycosylated hemoglobin,glycated albumin,and blood routine test. Results The prevalence of NAFLD was higher in CC group than in Con group（60.9%vs 46.1%,P〈0.01）.The levels of TG and BMI were higher in CC group than in Con group（P〈0.05）.Logistic regression analysis showed that history of cholecystectomy,sex,waist circumference（WC）,TG,and BMI were independently correlated with NAFLD （OR=1.508,1.373,1.046,2.056,1.178,P〈0.01）. Conclusion Cholecystectomy history is independently correlated with NAFLD in patients with T2DM.