摘要
目的探讨代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)伴2型糖尿病(type 2 diabetes mellitus,T2DM)患者内脏脂肪(visceral fat,VFA)与肝纤维化的关系。方法纳入T2DM患者418例,依据腹部超声分为T2DM组(n=136),T2DM+MAFLD组(n=282),依据肝纤维化评分(non-alcoholic fatty liver disease fibrosis score,NFS)将T2DM+MAFLD组分为肝纤维化低危组(n=94)、中危组(n=154)、高危组(n=34),测定上述患者VFA及相关血清学指标。结果与T2DM组相比,T2DM+MAFLD组患者体重指数(body mass index,BMI)、腰围(waist circumference,WC)、腹围(hip circumference,HC)、VFA、皮下脂肪(subcutaneous fat area,SFA)、三酰甘油(triglyceride,TG)、丙氨酸转氨酶(alanine transaminase,ALT)、白蛋白(albumin,Alb)显著升高,而病程、高密度脂蛋白胆固醇(high density lipoprotein cholesferol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)显著降低;T2DM+MAFLD各亚组血小板(platelet,PLT)比较:高危组>中危组>低危组,肝纤维化高危组BMI、VFA显著升高,TC、LDL-C、ALT显著降低,差异有统计学意义(P<0.05);T2DM+MAFLD患者VFA及SFA与体重(weight,W)、BMI、白细胞(white blood cell,WBC)、ALT、AST呈正相关,与病程、HDL-C呈负相关;Logistic回归显示,BMI、VFA、PLT、ALT、Alb是T2DM+MAFLD患者发生肝纤维化的影响因素。结论T2DM合并MAFLD患者肝纤维化风险与BMI、VFA、PLT、ALT、Alb具有相关性。
Objective To explore the relationship between visceral fat area(VFA)and liver fibrosis in patients with metabolic associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM).Methods In total,418 patients with T2DM were included,and divided into T2DM group(n=136)and T2DM+MAFLD group(n=282)based on abdominal ultrasound.According to non-alcoholic fatty liver disease fibrosis score(NFS),T2DM-MAFLD group was subdivided into low-risk subgroup(n=94),moderate-risk subgroup(n=154),and high-risk subgroup(n=34).VFA and related serological indexes of those patients were determined.Results Compared with the T2DM group,patients in the T2DM+MAFLD group had significantly increased body mass index(BMI),waist circumference(WC),hip circumference(HC),VFA,subcutaneous fat area(SFA),triglyceride(TG),alanine transaminase(ALT),and albumin(Alb)but significantly shorter course of disease and significantly reduced high density lipoprotein cholesferol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).Comparison of platelet(PLT)in T2DM+MAFLD subgroups showed the highest PLT in high-risk subgroup,followed by moderate-risk subgroup and low-risk subgroup;high-risk subgroup had significantly increased BMI and VFA,and significantly decreased TC,LDL-C and ALT,suggesting a significant difference(P<0.05).VFA and SFA in T2DM+MAFLD groups were positively correlated with weight(W),BMI,white blood cell(WBC),ALT and AST,and negatively correlated with the course of disease and HDL-C.Logistic analysis showed that BMI,VFA,PLT,ALT,and Alb were the influencing factors for developing liver fibrosis in patients with T2DM+MAFLD.Conclusion The findings of this study show that the risk of liver fibrosis in patients with T2DM and MAFLD is associated with BMI,VFA,PLT,ALT,and Alb.
作者
贺佳
魏枫
刘美岚
周坤
HE Jia;WEI Feng;LIU Mei-lan;ZHOU Kun(Department of Endocrinology,the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology,Inner Mongolia,Baotou 014000,China)
出处
《河北医科大学学报》
CAS
2024年第5期566-572,共7页
Journal of Hebei Medical University
基金
内蒙古草原英才计划(2013144)
内蒙古自治区卫生健康科技计划项目(202202235)。
关键词
糖尿病
2型
代谢相关脂肪性肝病
肝纤维化
diabetes mellitus,type 2
metabolicassociated fatty liver disease
hepatic fibrosis