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刘阳, 于世家, 文涛. 2型糖尿病合并非酒精性脂肪肝相关影响因素分析[J]. 中国公共卫生, 2018, 34(8): 1168-1170. DOI: 10.11847/zgggws1119442
引用本文: 刘阳, 于世家, 文涛. 2型糖尿病合并非酒精性脂肪肝相关影响因素分析[J]. 中国公共卫生, 2018, 34(8): 1168-1170. DOI: 10.11847/zgggws1119442
Yang LIU, Shi-jia YU, Tao WEN. Influencing factors of non-alcoholic fatty liver disease among patients with type 2 diabetes[J]. Chinese Journal of Public Health, 2018, 34(8): 1168-1170. DOI: 10.11847/zgggws1119442
Citation: Yang LIU, Shi-jia YU, Tao WEN. Influencing factors of non-alcoholic fatty liver disease among patients with type 2 diabetes[J]. Chinese Journal of Public Health, 2018, 34(8): 1168-1170. DOI: 10.11847/zgggws1119442

2型糖尿病合并非酒精性脂肪肝相关影响因素分析

Influencing factors of non-alcoholic fatty liver disease among patients with type 2 diabetes

  • 摘要:
      目的  探讨2型糖尿病合并非酒精性脂肪肝(NAFLD)患者相关影响因素,为相关疾病防治提供依据。
      方法  回顾性分析2014 — 2017年间446例2型糖尿病住院患者的临床资料,通过腹部B超进行定性检查,根据结果分为无NAFLD组和NAFLD组。收集2组人群的一般资料,检测糖化血红蛋白(HbA1c)、体质指数(BMI)、腰围/臀围比值(WHR)、颈动脉内膜中层厚度(IMT)、血脂、肝功能、肾功能等指标,采用logistic 回归分析,探讨2型糖尿病合并NAFLD的相关影响因素。
      结果  与无NAFLD组比较,NAFLD组2型糖尿病患者BMI、血尿酸、谷丙转氨酶(ALT)、甘油三酯(TG)、胆固醇、WHR、右颈动脉IMT、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)分别为(27.71 ± 3.43)kg/m2、(307.91 ± 72.89)μmol/L、(34.25 ± 22.13)U/L、(2.52 ± 0.89)mmol/L、(5.41 ± 1.06)mmol/L、(0.932 ± 0.12)、(0.968 ± 0.11)mm、(3.36 ± 0.91)mmol/L、(4.55 ± 1.06) 均升高,差异均有统计学意义(P < 0.05)。logistic 回归分析显示,BMI、血尿酸、TG、HOMA-IR、WHR、右颈动脉IMT是NAFLD主要危险因素(β 值分别为0.192、0.363、0.562、0.219、0.170、0.356)。
      结论  BMI、血尿酸、TG、WHR、右颈动脉IMT及胰岛素抵抗是2型糖尿病合并NAFLD的重要危险因素。

     

    Abstract:
      Objective  To investigate influencing factors of type 2 diabetes mellitus (T2DM) among patients with non-alcoholic fatty liver disease (NAFLD) and to provide evidences for the prevention and treatment of related diseases.
      Methods  We randomly extracted medical records of 446 T2DM patients hospitalized in a tertiary hospital between 2014 and 2017 and assigned them into a NAFLD group (n = 186) and a non-NAFLD group (n = 260) based on abdominal ultrasonography. Then we collected data on all participants' clinical examinations and laboratory tests, including body mass index (BMI), waist/hip ratio (WHR), carotid intima-media thickness (IMT), hemoglobin A1c (HbA1c), blood lipids, liver function, and renal function. We adopted logistic regression to explore impact factors of NAFLD among the T2DM inpatients.
      Results  Significantly higher BMI (27.71 ± 3.43 kg/m2), WHR (0.932 ± 0.12), right carotid artery IMT (0.968 ± 0.11 mm), serum uric acid (SUA, 307.91 ± 72.89 μmol/L), alanine aminotransferase (34.25 ± 22.13 U/L), triglyceride (TG, 2.52 ± 0.89 mmol/L), total cholesterol (5.41 ± 1.06 mmol/L), low density lipoprotein cholesterol (3.36 ± 0.91mmol/L), and homeostatic model assessment for insulin resistance (HOMA-IR, 4.55 ± 1.06%) were observed among the participants with NAFLD compared to those among the participants without NAFLD (P < 0.05 or P < 0.01 for all). Logistic regression analysis revealed that main risk factors for NAFLD were BMI (β = 0.185), SUA (β = 0.351), TG (β = 0.587), HOMA-IR (β = 0.236), WHR (β = 0.170), and right carotid artery IMT (β = 0.356) among the participants.
      Conclusion  BMI, SUA, TG, WHR, right carotid IMT and insulin resistance are important risk factors for NAFLD among T2DM patients.

     

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