新诊断2型糖尿病合并超重/肥胖患者肝脏脂肪含量及其影响因素

Hepatic fat content and its influencing factors in newly diagnosed type 2 diabetic patients with overweight/obesity

目的探讨新诊断T2DM合并超重/肥胖患者肝脏脂肪含量及其影响因素。方法选取2018年1~7月于苏州大学附属第一医院内分泌科住院的新诊断T2DM患者53例,根据BMI分为非肥胖组(n=23,BMI<25 kg/m^2)与超重/肥胖组(n=30,BMI≥25 kg/m^2),比较两组资料,分析肝脏脂肪分数(HFF)与各指标的相关性。结果肥胖组BMI、WC、臀围(HC)、WHR、FPG、胰岛素抵抗指数(HOMA-IR)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、SUA、TG、高敏C反应蛋白(hsC-RP)及HFF较非肥胖组增高(P<0. 05)。相关性分析显示,HFF与BMI、WC、HC、WHR、FPG、FIns、HOMA-IR、ALT、AST、谷氨酰转肽酶、Scr、SUA、TG、hsC-RP均呈正相关(r=0. 669、0. 663、0. 637、0. 337、0. 313、0. 541、0. 597、0. 649、0. 685、0. 492、0. 284、0. 485、0. 302、0. 577,P<0. 05)。多元逐步回归分析显示,WC、hsC-RP及ALT是HFF的影响因素。结论 T2DM合并超重/肥胖患者肝脏脂肪含量明显增高,WC、hsC-RP及ALT是HFF的影响因素。

Objective To figure out the hepatic fat content in newly-diagnosed type 2 diabetic patients(T2 DM)with overweight/obesity and to explore its influencing factors.Methods53 newly-diagnosed T2 DM patients were enrolled in this study and divided into two groups according to body mass index(BMI):non-obese diabetic group(n=23,BMI<25 kg/m^2)and overweight/obese diabetic group(n=30,BMI≥25 kg/m^2). The liver was scanned with magnetic resonance imaging dixon technique. The index of hepatic fat fractions(HFF)was measured and calculated. The correlation was evaluated by pearson or spearman analysis. Multiple linear stepwise regression analysis was used to analyze the relationship between HFF and metabolic indexes.ResultsCompared with the non-obese diabetic group,the levels of BMI,waist circumference(WC),hip circumference(HC),W/H ratio,fasting plasma glucose(FPG),insulin resistance index(HOMA-IR),alanine aminotransferase(ALT),glutamic oxaloacetic transaminase(AST),uric acid(UA),total triglyceride(TG),high-sensitivity C-reactive protein(hsC-RP)and HFF were significantly increased in the overweight/obese diabetic group(P<0. 05). Correlation analysis showed that HFF was positively correlated with BMI,WC,HC,W/H,FPG,fasting insulin(FIns),HOMA-IR,ALT,AST,GGT,creatinine,SUA,TG and hsC-RP(r=0. 669,0. 663,0. 637,0. 337,0. 313,0. 541,0. 597,0. 649,0. 685,0. 492,0. 284,0. 485,0. 302,0. 577,P<0. 05). Multiple linear stepwise regression analysis showed that WC,hsC-RP and ALT were the influencing factors of HFF.ConclusionHe-patic fat content in T2 DM patients with overweight/obesity was significantly higher than that of non-obese diabetic patients. WC,hsC-RP and ALT were the influencing factors of HFF.