初诊2型糖尿病患者非酒精性脂肪性肝病危险因素分析

Analysis of risk factors for non-alcoholic fatty liver disease in patients with newly diagnosed type 2 diabetes

目的探讨初诊2型糖尿病患者发生非酒精性脂肪性肝病(NAFLD)的危险因素并分析其临床特征。方法纳入257例初诊2型糖尿病患者,按NAFLD的诊断标准分为NAFLD组(174例)和非NAFLD组(83例)。分析体重指数(BMI)、内脏脂肪指数(VAI)、血压、血糖、血脂、胰岛素抵抗相关指数等与NAFLD的关系。结果初诊2型糖尿病患者NAFLD占67.7%。logistic回归分析显示,2型糖尿病患者BMI、VAI、三酰甘油葡萄糖乘积(TyG)指数及天门冬氨酸氨基转移酶与NAFLD独立相关。结论高BMI、高VAI和高TyG指数是初诊2型糖尿病患者发生NAFLD的独立危险因素,2型糖尿病患者控制体重、减少内脏脂肪堆积、改善胰岛素抵抗对于预防NAFLD的发生发展具有重要意义。

Objective To investigate the clinical characteristics of type 2 diabetes(T2D)patients with non-alcoholic fatty liver disease(NAFLD),and to explore the risk factors for NAFLD in patients with T2D.Methods 257 patients with newly diagnosed T2D were enrolled into the study,compromised of 174 patients with NAFLD and 83 patients without NAFLD according to the results of abdominal color Doppler ultrasound.We evaluated the association of body mass index(BMI),visceral adiposity index(VAI),blood pressure,blood glucose,lipid dysmetabolism,and insulin resistance related index with NAFLD.Results NAFLD accounted for 67.7%of newly diagnosed T2D patients.Logistic regression showed that BMI,VAI,triglyceride-glucose product(TyG)index,and aspartate aminotransferase were independently influencing factors of NAFLD.Conclusion High BMI,high VAI,and high TyG index are independent risk factors for NAFLD in patients with T2D.Therefore,weight control,reduction of visceral fat accumulation,and insulin resistance amelioration in patients with T2D are of great significance for preventing the development of NAFLD.