摘要
目的研究2型糖尿病合并非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的临床特点及其相关因素。方法在279例资料完整的2型糖尿病患者中应用B型超声检查筛选NAFLD。比较合并NAFLD(合并NAFLD组,n=101)与不合并NAFLD(对照组,n=178)的2型糖尿病患者之间的临床特征及血糖、胰岛素敏感性、血脂、肝酶等代谢指标的不同,并分析影响NAFLD的因素。结果 (1)合并NAFLD组的体重指数(BMI)、腰围(WC)、三酰甘油(TG)、谷丙转氨酶(GPT)、C-反应蛋白(CRP)、空腹C肽(Fc-P)和血尿酸(Ua)水平均高于对照组(P<0.05);(2)NAFLD与WC、TG、CRP、GFR、FC-p、Ua呈正相关(r值分别为0.2351、0.2953、0.1325、0.1381、0.2729、0.2632,P<0.05),与Lp(a)呈负相关(r=-0.1475,P<0.05)。结论胰岛素抵抗、肥胖、高三酰甘油的2型糖尿病患者常伴有NAFLD,升高的BMI、Ua、FC-p可预示2型糖尿病患者非酒精性脂肪性肝病的发生。
Objective To analyze the clinical characteristics and related factors of the type 2 diabetes mellitus combined with nonalcoholic fatty liver disease（NAFLD）.Methods The NAFLD was screened by B-ultrasound in 279 diabetes mellitus patients with detailed data,and the differences of metabolic indexes including blood glucose,insulin sensitivity,blood fat,hepatic enzymes and clinical characteristics were compared between the diabetic patients with or without NAFLD,and the factors influencing NAFLD were analyzed.Results（1）The levels of BMI,WC,TG,GPT,CRP,FC-p and Ua in NAFLD＋ group were significantly higher than those of NAFLD-group（P〈0.05）;（2）NAFLD was positively correlated with WC,TG,CRP,GPT,FC-p,Ua（P〈0.05）,however,which was negatively correlated with Lp（a）（P〈0.05）,but there was no significant correlation with disease course,blood pressure,serum insulin,HbA1c and TC（P〈0.05）.（3）The multivariate regression analysis showed that after the calibration of the factors including age,disease course,CRP,HbA1c,the most principal factors influencing NAFLD in diabetic patients were BMI,FC-p and Ua.Conclusion The type 2 diabetic patients with insulin resistance,obesity,hypertriglyceridemia are always combined with NAFLD,and the increase of BMI,Ua,FC-p can predict the incidence of NAFLD in type 2 diabetic patients.
出处
《河北医药》
CAS
2010年第11期1369-1371,共3页
Hebei Medical Journal
关键词
糖尿病
2型
非酒精性脂肪肝
胰岛素抵抗
多因素分析
diabetes mellitus
type 2
nonalloholic fatty liver disease
insulin resistance
multifactor analysis
