2型糖尿病合并非酒精性脂肪肝患者临床特点分析

目的回顾性分析2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）患者的临床特点。方法将228例T2DM患者根据是否合并NAFLD分为实验组和对照组，实验组116例为合并NAFLD患者，对照组112例为非脂肪肝患者，分别测定两组患者的身高、体重、腰围、臀围，计算体重指数（BMI）及腰臀比（WHR），测定血脂、肝功能、空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbAlc）、空腹胰岛素（FINS）、餐后2h胰岛素（2hlNS）、胰岛素敏感指数（ISI）、胰岛素抵抗指数（HOMA—IR）、颈动脉内膜中层厚度（IMT），对以上指标进行比较。结果实验组相比对照组，BMI、低密度脂蛋白胆固醇（LDL—C）、甘油三酯（TG）、HOMA—IR、大血管病变率均较高，差异有高度统计学意义（P〈0．01）。结论T2DM合并NAFLD的患者血脂代谢紊乱、超重、血糖升高和胰岛素抵抗均明显．而且大血管病变的患病率高，在临床上应加强综合治疗。

The clinical characteristics of type 2 diabetes mellitus patients combined with nonalcoholic fatty liver disease

Objective To analyze type 2 diabetes mellitus （T2DM） patients with non-alcoholic fatty liver disease （NAFLD） patients with clinical features. Methods A total of 228 cases of T2DM patients according to whether with or without NAFLD were divided into experimental group and control group, 116 cases in the experimental group for pa- tients with NAFLD, 112 cases of the control group for the patients without fatty liver, two groups of patients with height, weight, waist circumference, hip circumference were measured, and body mass index （BMI） and waist hip ratio （WHR）, serum lipids, liver function, fasting blood glucose （FPG）, 2 hour postprandial blood glucose （2 hPG）, gly cosylated hemoglobin （HbAlc）, fasting insulin （FINS）, 2 hour postprandial insulin （2 hINS）, insulin sensitivity index （ISI）, insulin resistance index （HOMA-IR）, carotid artery intima-media thickness （IMT）, compared the above index. Results The experimental group compared with the control group, BMI, low density lipoprotein cholesterol （LDL-C）, triglyceride （TG）, HOMA-IR, macrovascular disease rate was high, the difference was statistically significant （P 〈 0.01 ）. Conclusion T2DM combined with NAFLD in patients with dyslipidemia, overweight, blood glucose and insulin resistance were significantly, and the prevalence rate of vascular disease in clinical, should strengthen the comprehensive treatment.