摘要
目的探讨2型糖尿病(T2DM)患者合并非酒精性脂肪性肝病(NAFLD)的相关影响因素及其与颈动脉粥样硬化的关系。方法选取2012年在我院内分泌科住院的T2DM患者278例为研究对象。T2DM符合WTO 1999年提出的糖尿病诊断标准,NAFLD符合中华医学会肝脏病学分会脂肪肝和酒精性肝病学组《非酒精性脂肪性肝病诊疗指南》中提出的诊断标准。根据是否合并NAFLD将受试者分为T2DM非NAFLD组152例,T2DM合并NAFLD组126例。记录两组患者的身高、体质量、腰围、臀围、血压、病程等一般资料,检测肝功能及糖、脂代谢水平,测定颈动脉粥样硬化斑块。结果两组患者的性别、年龄、血压间差异无统计学意义(P>0.05)。T2DM合并NAFLD组体质指数(BMI)、腰臀比、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、三酰甘油(TG)、胰岛素抵抗指数(HOMA-IR)、颈动脉内膜中层厚度(IMT)、颈动脉粥样硬化发生率高于对照组,而高密度脂蛋白胆固醇(HDL-C)低于对照组,差异均有统计学意义(P<0.05)。偏相关分析显示颈动脉IMT与HOMA-IR呈正相关(r=0.368,P<0.05)。多元逐步Logistic回归分析显示T2DM合并NAFLD和HOMA-IR是T2DM患者发生颈动脉粥样硬化的危险因素(P<0.05);BMI、TG、腰臀比、ALT、HOMA-IR是T2DM患者发生NAFLD的独立危险因素(P<0.05)。结论 T2DM合并NAFLD患者更易出现脂代谢异常、胰岛素抵抗及动脉粥样硬化,且NAFLD的发生与BMI、TG、腰臀比、ALT、HOMA-IR相关。
Objective To explore the related influencing factors of type 2 diabetes mellitus （T2DM） combined with nonalcoholic fatty liver disease （NAFLD） and its relationship to carotid artery atherosclerosis （CAA）. Methods A total of 278 T2DM patients hospitalized in this hospital in 2012 were divided, based on whether combined with NAFLD, into non -NAFLD group （ n = 152） , NAFLD group （ n = 126 ）. Height, weight, waist circumference （ WC ） , hip circumference （ HC ） , blood pressure （ BP）, disease duration and other general data were recorded, levels of liver enzymes and glucolipid metabolism detec- ted, and carotid atherosclerotic plaques （CAP） determined. Results No significant difference in gender, age, BP between 2 groups （P 〉 0. 05 ）. The body mass index （BMI）, waist- hip ratio （WHR）, alanine aminotransferase （LT）, aspartate amin- otransferase （ AST）, triglyceridc （ TG）, insulin resistance index （ HOMA - IR）, carotid intima - media thickness （ IMT）, in- cidence of CAA were higher, high density lipoprotein cholesterol （HDL- C ） lower in NAFLD group than in non - NAFLD group, the difference was significant （ P 〈 O. 05 ）. Partial correlation analysis showed that IMT was positively correlated with HOMA - IR （ r = 0. 368, P 〈 0. 05 ）. Stepwise Logistic regression analysis showed that T2DM combined with NAFLD and HOMA - IR were risk factors of CAA （ P 〈 0.05 ） ; BMI, TG, WHR, ALT, HOMA - IR were independent risk factors of NAFLD （ P 〈 0. 05 ）. Conclusion Dyslipidemia, insulin resistance and CAA are more vulnerable to T2DM patients combined with NAFLD. NAFLD is related to BMI, TG, WHR, ALT, HOMA-IR.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第35期4131-4134,共4页
Chinese General Practice
关键词
糖尿病
2型
颈动脉
内膜中层厚度
动脉粥样硬化
脂肪肝
非酒精性
Diabetes mellitus, type 2
Carotid arteries
Intima - media thickness
Atherosclerosis
Fatty liver,non - alcoholic
