上海某社区65岁以上老年人糖尿病合并脂肪肝影响因素分析

Analysis of the influencing factors of diabetes with fatty liver in the elderly over 65 years old in a community of Shanghai

目的:了解老年人糖尿病合并脂肪肝影响因素,为老年糖尿病患者预防脂肪肝提供依据。方法:选取2018年8-10月在上海天平街道社区卫生服务中心体检的65周岁以上糖尿病患者357例。190例不伴有脂肪肝的糖尿病患者为对照组,其中男性78例,女性112例,平均年龄为(74.19±6.464)岁;167例伴有脂肪肝的糖尿病患者为观察组,其中男性69例,女性98例,平均年龄为(72.65±5.961)岁。比较2组患者的体质指数(BMI)、腰围/臀围比(WHR)、尿素氮(BUN)、血肌酐(CRE)、尿酸(UA)、空腹血糖(FPG)、丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素(TBIL)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、总胆固醇(TC)、三酰甘油(TG)。结果:观察组患者BMI、WHR、UA、FPG、TG、ALT、AST、AST/ALT等指标均高于对照组,HDL-c低于对照组,差异均具有统计学意义(P<0.05)。BMI和TG是老年糖尿病合并脂肪肝的主要危险因素(OR=1.297,95%CI为1.182~1.432和OR=1.634,95%CI为1.184~2.253)。结论:需加强对糖尿病患者进行体重控制和血脂异常防治的健康教育和干预,降低发生脂肪肝的风险。

Objective:To understand the influencing factors of diabetes with fatty liver in the elderly and provide evidence for the prevention of fatty liver in the elderly patients with diabetes.Methods:From August to October 2018357 diabetic patients over 65 years old were selected from Tianping Community Health Service Center,Shanghai,and 190 diabetic patients without fatty liver were a control group,there were 78 males and 112 females with an average age of(74.19±6.464)years;167 diabetic patients with fatty liver were an observation group,there were 69 males and 98 females with an average age of(72.65±5.961)years.The body mass index(BMI),waist/hip ratio(WHR),blood urea nitrogen(BUN),blood creatinine(CRE),uric acid(UA),fasting blood glucose(FPG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c),total cholesterol(TC),and triacylglycerol(TG)were compared between the two groups.Results:The BMI,WHR,UA,FPG,TG,ALT,AST,AST/ALT and other indexes in the observation group were higher than those in the control group;HDL-c in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).BMI and TG were the main risk factors for elderly diabetes with fatty liver(OR=1.297,95%CI 1.182-1.432 and OR=1.634,95%CI 1.184-2.253).Conclusion:It is necessary to strengthen the health education and intervention of weight control and prevention of dyslipidemia in diabetic patients,so as to reduce the risk of fatty liver.