体重指数与2型糖尿病患者非酒精性脂肪性肝病的关系

对我院健康体检中心311例新诊断2型糖尿病患者及从既往无糖尿病病史且糖耐量正常的体检者中随机选取的366例体检者（对照组），进行病史询问、体检及血糖、肝肾功能、血脂、腹部彩色超声等检查，分析其非酒精性脂肪性肝病（NAFLD）患病情况。结果显示，对照组366例共检出NAFLD67例（患病率18．3％），其中轻度51例（患病率13．9％），中度15例（4．1％），重度1例（0．3％）。311例新诊断的2型糖尿病患者中共检出NAFLD144例（患病率46．3％），其中轻度85例（患病率27．3％），中度53例（17．0％），重度6例（1．9％）。糖尿病患者体重指数（BMI）〈23．0kg／m2组、23．0～24．9kg／m2组和25．0—29．9kg／m2组中NAFLD患病率及轻中重度脂肪肝患病率明显高于对照组（均P〈0．01）；当BMI≥30kg／m2时，两组NAFLD患病率差异无统计学意义（P〉0．05）。两组NAFLD的患病率均随BMI的增加而升高，当BMI≥25．0ks／m2时升高最为明显，明显高于BMI〈25kg／m2者（P〈0．01）。且随着BMI的增加，2型糖尿病患者合并代谢综合征的患病率亦明显升高。提示，2型糖尿病患者NAFLD患病率较高，伴肥胖患者更易发生NAFLD。

Relationship of body mass index and non-alcoholic fatty fiver disease in patients with type 2 diabetes mellitus

To investigate the relationship of body mass index and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus. Three hundred and eleven patients with type 2 diabetes mellitus diagnosed according WHO 1999 consensus criteria and 366 healthy subjects were enrolled in the study. Medical history was acquired and physical examination was conducted, and blood sugar, liver and kidney functions, lipid profile and abdominal ultrasonography color were examined. Sixty seven out of 366 healthy subjects were confirmed to have non-alcoholic fatty liver disease (NAFLD) ,including 51 mild case ( 13.9％ ) ,15 moderate cases(4. 1％ ) and 1 severe case(0. 3％ ) ; while in 311 diabetic patients NAFLD was detected in 144 cases, including 85 mild cases (27.3％) ,53 moderate cases( 17.3％ )and 19 severe cases( 1.9％ ). The prevalence rate of NAFLD was higher in diabetic patients than control group in BMI ＜ 23.0 kg/m2 group, 23.0 -24. 9 kg/m2 group and 25.0 -29. 9 kg/m2 group(P ＜0. 01 ) ; however, there was no difference between two groups when BMi ≥30 kg/m2 (P ＞0. 05 ). The prevalence of NAFLD increased with BMI whether in control group or in diabetic group, especially when BMI ＞ 25 kg/m2. In addition to the prevalence of NAFLD, metabolic syndrome increased with BMI in diabetic patients. These findings indicate that type 2 diabetic patients have a high prevalence of NAFLD, especially in obese patients.