摘要
[目的]探讨2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）与胰岛素抵抗、血脂紊乱、尿酸的关系及其发病因素.[方法]对本院2011年1~8月的133例T2DM住院患者的临床资料进行回顾性分析,根据腹部B超结果分为合并NAFLD组（A组,70例）和不合并NAFLD组（B组,63例）,分析比较两组体重指数（BMI）、腰围（WL）、空腹胰岛素、餐后2 h胰岛素、脂代谢指标、尿酸的水平.[结果]与B组比较,A组的T2DM患者的BMI、WL、空腹胰岛素、血甘油三酯（TG）,低密度脂蛋白胆固醇（LDL-C）、胆固醇、尿酸显著增高（P均＜0.05）;同时高密度脂蛋白（HDL-C）显著降低（P＜0.05）;Logistic回归分析显示：BMI、WL、TG、HDL-C对T2DM合并NAFLD的发生有显著影响（P均＜0.05）.[结论]2型糖尿病患者合并NAFLD,与肥胖（主要是腹型肥胖）、血脂紊乱、尿酸增高相关;而与糖尿病病程、血糖控制程度、糖化血红蛋白不相关,导致糖尿病合并NAFLD的最主要原因为胰岛素抵抗及其所包含的脂代谢紊乱.
[Objective] To explore the risk factors of type 2 diabetes mellitus（T2DM） with nonalcoholic fatty liver disease（NAFLD） and its relationship with insulin resistance, lipids disorder and uric acid. [Meth-ods] The clinical data of 133 T2DM patients in our hospital from Jan. 2011 to Aug. 2011 were analyzed retro-spectively. According to abdominal B-ultrasound examination, all these patients were divided into the group with NAFLD group（group A, n = 70） and the group without NAFLD group（group B, n = 63）. Body mass in-dex（BMI）, waistline（WL）, fasting insulin, postprandial 2h insulin, lipid metabolism index and uric acid be-tween two groups were analyzed and compared. [Results] Compared with group B, BMI, WL, fasting insu-lin, serum TG, LDL-C, CHO and uric acid level in T2DM patients in group A increased significantly（all P〈 0.05）, while HDL-C level decreased significantly（ P〈0.05）. Logistic regression analysis showed that BMI, WL, TG and HDL-C had remarkable effect on the pathogenesis of T2DM with NAFLD（all P 〈0.05）. [Con-clusion]T2DM with NAFLD is correlated with obesity（abdominal obesity）, lipid disorder and the elevated lev-el of uric acid, but not related to the course of diabetes mellitus, blood glucose control and glycosylated hemo-globin. The main causes of T2DM with NAFLD are insulin resistance and lipid disorder.
出处
《医学临床研究》
CAS
2012年第5期941-943,共3页
Journal of Clinical Research
