非酒精性脂肪性肝病与代谢综合征相关 2 型糖尿病的相关性研究

目的探讨非酒精性脂肪性肝病（NAFLD）与代谢综合征（MS）相关2型糖尿病的相关性。方法选取2010年4月～2011年10月在义乌市中医医院进行健康体检的、并检出患有MS相关2型糖尿病343例（单纯MS相关2型糖尿病组）和NAFLD361例（单纯NAFLD组）患者，共704例作为研究对象。由受过专业培训的医护人员测量其身高、体重，计算体重指数（BMI）；测量记录腰围及静息30min后的收缩压和舒张压。应用全自动血液生化分析仪对各项生化指标进行监测，主要监测指标有：清晨空腹血糖、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）和丙氨酸氨基转移酶（A叩）。结果单纯MS相关2型糖尿病组肥胖和高血压的患病率高于单纯NAFLD组；而血脂异常者所占的比例则低于单纯NAFLD组，差异有统计学意义（P〈0．05）。实验室生化分析结果表明，单纯MS相关2型糖尿病患者血压波动度、腰围尺寸、HDL—C与TG均明显高于单纯NAFI．D组（P〈0．05），而两组患者的BMI、清晨空腹血糖、LDL—C、ALT及TC比较，差异无统计学意义（P〉0．05）。多因素Logistic回归分析结果显示，BMI、腰围尺寸以及ALT、TG、TC与NAFLD表现出相关性（P〈0．05），TG、腰围、ALT为MS相关2型糖尿病发病相关因素；TG、腰围、ALT为两组共同的发病相关危险因素。结论NAFLD和MS相关2型糖尿病之间确实存在相互关系，两者有共同的发病相关因素。

Correlation studies between nonalcoholic fatty liver disease and metabolic syndrome associated with type 2 diabetes

Objective To investigate the correlation of nonalcoholic fatty liver disease （NAFLD） and metabolic syn- drome （MS） associated with type 2 diabetes. Methods 704 cases of residents were chosen from April 2010 to October 2011 in Yiwu Traditional Chinese Medicine Hospital for physical examination, 343 cases were with MS associated with type 2 diabetes （MS associated with type 2 diabetes group）, 361 cases were with NAFLD （pure NAFLD group）, the height, weight, calculate body mass index （BMI） were measured by trained medical personnel; waist circumference, resting systolic and diastolic blood pressure were measured after 30 minutes. The automatic biochemical analyzer was used to biochemical indicators monitoring, including 12 h after fasting venous blood sugar, triglyceride （TG）, total cholesterol （TC）, high-density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and alanine aminotransferase （ALT）. Results The prevalence of obesity and hypertension in MS associated with type 2 diabetes group were higher than those in pure NAFLD group; and abnormal proportion of blood lipid was lower than that of pure NAFLD group, the difference was statistically significant （P 〈 0.05）. The results of laboratory biochemical indexes showed that, blood pressure fluctuations, waist circumference, HDL-C and TG levels in MS associated with type 2 dia- betes were significantly higher than those of pure NAFLD group （P 〈 0.05）, and two groups of patients with BMI, fast- ing glucose, LDL-C, ALT and TC levels had no statistically significant differences （P 〉 0.05）. Logistic regression analy- sis results showed that BMI, waist circumference, ALT, TC, TG were correlated with NAFLD （P 〈 0.05）, TG, waist cir- cumference, ALT were related factors for MS associated with type 2 diabetes morbidity; TG, waist circumference, the onset of ALT were mutual related risk factors for two groups. Conclusion NAFLD and MS associated with type 2 dia- betes have a mutual relationship certainly, they have a common pathogenesis related factor.