非酒精性脂肪性肝病合并2型糖尿病患者的临床特征及危险因素分析

Analysis of clinical characteristics and risk factors in patients with nonalcoholic fatty liver disease complicated with type 2 diabetes mellitus

目的探讨非酒精性脂肪性肝病(NAFLD)合并2型糖尿病(T2DM)患者的临床特征和危险因素。方法回顾性分析新疆医科大学第一附属医院2020年8月至2021年8月收治的349例NAFLD患者的临床资料,根据有无合并T2DM分为单纯NAFLD组(281例)和NAFLD合并T2DM组(68例)。收集临床资料,分析NAFLD发生T2DM的危险因素。结果NAFLD合并T2DM组年龄、糖尿病家族史、空腹血糖、糖化血红蛋白高于单纯NAFLD组,高密度脂蛋白低于单纯NAFLD组,差异有统计学意义(P<0.05)。Spearson相关性分析显示,NAFLD合并T2DM与年龄、空腹血糖、糖化血红蛋白呈正相关(r>0,P<0.05);与高密度脂蛋白呈负相关(r<0,P<0.05)。logistic回归分析显示,年龄(OR=1.037)、空腹血糖(OR=1.420)、高密度脂蛋白(OR=0.301)、糖化血红蛋白(OR=1.186)是NAFLD发生T2DM的独立危险因素(P<0.05)。受试者操作特征曲线分析显示,空腹血糖、糖化血红蛋白、高密度脂蛋白对NAFLD发生T2DM具有诊断价值(P<0.05)。结论年龄、空腹血糖、高密度脂蛋白、糖化血红蛋白是NAFLD发生T2DM的独立危险因素。

Objective To investigate the clinical characteristics and risk factors of nonalcoholic fatty liver disease(NAFLD)patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 349 NAFLD patients admitted to the First Affiliated Hospital of Xinjiang Medical University from August 2020 to August 2021 were retrospectively analyzed.According to the presence or absence of T2DM,the patients were divided into a simple NAFLD group(281 cases)and a NAFLD combined T2DM group(68 cases).The clinical data were collected to analyze the risk factors of NAFLD developing T2DM.Results The age,family history of diabetes,fasting blood glucose,and glycosylated hemoglobin in the NAFLD combined with T2DM group were higher than those in the simple NAFLD group,while the high-density lipoprotein was lower than that in the simple NAFLD group,and the differences were statistically significant(P<0.05).Spearson correlation analysis showed that NAFLD complicated with T2DM was positively correlated with age,fasting blood glucose,and glycosylated hemoglobin(r>0,P<0.05);it was negatively correlated with high-density lipoprotein(r<0,P<0.05).Logistic regression analysis showed that age(OR=1.037),fasting blood glucose(OR=1.420),high-density lipoprotein(OR=0.301),and glycosylated hemoglobin(OR=1.186)were independent risk factors for T2DM in NAFLD(P<0.05).Receiver operating characteristic curve analysis showed that fasting blood glucose,glycosylated hemoglobin,and high-density lipoprotein had diagnostic value for NAFLD-induced T2DM(P<0.05).Conclusion Age,fasting blood glucose,high-density lipoprotein,and glycosylated hemoglobin were independent risk factors for NAFLD to develop T2DM.