2型糖尿病患者合并脂肪肝的多因素分析

Multiple factor analysis on nonalcoholic steatohepatitis in patients with type 2 diabetes

目的 探讨影响糖尿病合并脂肪肝的主要危险因素。方法 2 94例住院治疗的糖尿病患者根据B超检查结果分为糖尿病合并脂肪肝组 (DFL)与糖尿病对照组 (DM组 )。并收集同期的非糖尿病非酒精性脂肪肝 (NASH)患者 49例作为对照。结果 ( 1)糖尿病合并脂肪肝的发病率为 41.15 %;( 2 )与DFL有关的危险因素包括体重、体重指数、腰臂比值、血压、空腹胰岛素、餐后 2小时胰岛素、胆固醇、甘油三酯、载脂蛋白B、HOMA IR ,其中最主要的两个危险因素是甘油三酯和体重指数 ;( 3)糖尿病患者的性别、年龄、糖尿病病程、血糖和血清转氨酶水平两组比较 ,差异无显著性 ;( 4 )DFL与非糖尿病NASH比较 ,HOMA IR差异无显著性。结论 ( 1)影响DFL的因素众多 ,主要因素是甘油三酯和体重指数 ;( 2 )虽然性别、血糖水平和年龄对NASH影响显著 ,但在糖尿病患者中它们的作用相对降低 ;( 3)DFL患者的肝酶活性一般没有明显变化。

Objective To evaluate the risk factors associated with diabetic fatty liver (DFL).Methods 294 diabetic inpatients were divided into two groups (DFL and DM)according to type B ultrasonic checkup results.49 cases of no diabetic nonalcoholic steatohepatitis were collected in same period.Results (1) Incidence rate of DFL of diabetic inpatients was 41.15%.(2)Risk factors related to DFL including BMI,WHR,SBP,DBP,FINS,PINS,TC,TG,Apo B and HOMA-IR.TC and BMI were the most important of all above variables.(3)There were not significant differences between DFL and DM groups on sex,age,FBG,PBG2h,duration of diabetes and serum enzyme activity of the liver.(4)There was not significant difference between DFL and no-diabetic NASH groups on HOMA-IR.Conclusion (1)The risk factors of DFL includes BMI,WHR,SBP,DBP,FINS,PINS,TC,TG,Apo B and HOMA-IR.TC and BMI are the most important factors of all.(2)Effects of sex,age,FBG,PBG2h on DFL in diabetic patients are decreased.(3)Serum enzyme activity of the liver in DFL has not changed.