摘要
目的分析非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者的临床特征及血清学指标变化,以初步探讨NAFLD合并T2DM的发病机制.方法收集2014-01/2016-01于永康市第一人民医院接受治疗的NAFLD患者360例(其中合并T2DM 196例,单纯NAFLD患者164例)和健康体检者170例(对照组),比较3组患者血脂、肝肾功能、血糖、尿酸(uric acid,UA)等血清学检验指标的差异.结果NAFLD合并T2DM组与单纯NAFLD组的总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、低密度脂蛋白(low-density lipoprotein,LDL)、谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartate transaminase,AST)、g-谷氨酰转肽酶(g-glutamyl transpeptidase,GGT)、空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、血红蛋白A1c(hemoglobin A1c,HbA1c)、UA水平均高于健康对照组,总蛋白(total protein,TP)、白蛋白(albnmin,ALB)均明显低于健康对照组,差异有统计学意义(P<0.05);NAFLD合并T2DM组TC、TG、LDL、ALT、AST、GGT、HbA1c、UA水平均高于单纯NAFLD组的,差异有统计学意义(P<0.05).结论肥胖、脂代谢紊乱和胰岛素抵抗等与NAFLD合并/不合并T2DM患者的发病密切相关.合理改变NAFLD患者的生活方式、减轻体质量、纠正血脂异常、改善胰岛素抵抗等措施,对于防治NAFLD合并T2DM具有重要的临床意义,应积极倡导并实施.
AIM To investigate the variations of serological indexes in patients with non-alcoholic fatty liver disease（NAFLD） and type 2 diabetes mellitus（T2DM） and discuss the influencing factors.METHODS Three hundred and sixty patients with NAFLD were included in an observation group,and they were divided them into 196 patients with NAFLD accompanied by T2DM and 164 patients with NAFLD alone.One hundred and seventy healthy people were included as a control group.Serological indexes were compared among the three groups.RESULTS The levels of serum total cholesterol（TC）,triacylglycerol（TG）,low-density lipoprotein（LDL）,alanine transaminase（ALT）,aspartate transaminase（AST）,γ-glutamyl transpeptidase（GGT）,fasting blood glucose（FBG）,fasting insulin（FINS）,and hemoglobin A1c（HbA1c）in the observation group were significantly higher than those in the control group（P〈0.05）,while serum total protein（TP） and albnmin（ALB） were significantly lower than those in the control group（P 〈 0.05）.The levels of TC,TG,LDL,ALT,AST,GGT,HbAlc and UA in patients with NAFLD and T2DM were significantly higher than those in patients with NAFLD alone（P 〈 0.05）.CONCLUSION Obesity,lipid metabolic disorder,insulin resistance and so on have a dose relationship with the pathogenesis of NAFLD combined with（or not） T2DM.Changing the life style reasonably,reducing weight,correcting abnormal blood lipids and improving insulin resistance have important clinical significance for prevention and treatment of NAFLD combined with（or not） T2DM.
出处
《世界华人消化杂志》
CAS
2016年第24期3635-3640,共6页
World Chinese Journal of Digestology
关键词
非酒精性脂肪性肝病
2型糖尿病
血清学指标
Non-alcoholic fatty liver disease
Type 2 diabetes mellitus
Serological index
