2型糖尿病并发非酒精性脂肪肝患者证素分析

目的 探讨2型糖尿病合并非酒精性脂肪肝的主要危险因素及中医的主要证型和病机。 方法采用病例对照研究的方法观察180例2型糖尿病并发脂肪肝和无脂肪肝患者的年龄、身高、体重、体重指数、空腹血糖、C肽、糖化血红蛋白（HbA1c）、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白(LDL-C)、餐后2 h C肽等指标。根据2型糖尿病中医证素分型，统计合并脂肪肝患者所占类型比例。 结果 2型糖尿病并发脂肪肝组与无脂肪肝组年龄、身高、空腹血糖、HbA1c、TC、LDL-C比较，差异无统计学意义（P>0.05）；脂肪肝组体重〔（73.4±11.7）kg〕、BMI(26.0±3.67)、空腹C肽〔(4.09±2.40)μg/L〕和餐后2 h C肽〔(6.38±5.46)μg/L〕、TG〔（2.81±2.33）mmol/L〕、HDL-C〔（1.07±0.06）mmol/L〕与无脂肪肝组体重〔（61.4±10.1）kg〕、BMI(22.8±3.23)、空腹C肽〔(2.47±1.74)μg/L〕和餐后2 h C肽〔(4.35±2.92)μg/L〕、TG〔（1.93±1.92）mmol/L〕、HDL-C〔（1.19±0.32）mmol/L〕比较，差异均有统计学意义（P<0.01，P<0.05）；合并脂肪肝组患者更易出现痰湿证。

Analysis on Associated Risk Factors and Syndrome Types in Diabetes Mellitus Type 2 Patients Complicated with Non-alcoholic Fatty Liver

Objective To explore the risk factors and the main TCM syndrome types associated with the diabetes mellitus type 2 （DM2） patients complicated with non-alcoholic fatty liver （FL）. Methods Adopted controlled trial method, the age, stature, body weight, and body mass index （BMI） of 180 DM2 patients were compared with those complicated with or without FL. And some related laboratory indexes, including the age, stature, body weight, BMI, fasting blood glucose （FBG） , C-peptide （CP） , glycosylated hemoglobin （HbAle） , triglyceride （TG）, total cholesterol （TC）, high and low density lipoprotein cholesterol （HDL-C and LDL-C）, and 2 h postrandial CP （2 h CP） , were compared as well. Moreover, patients＇ TCM syndrome types were classified. Resuits No significant differences were found between DM2 patients complicated with or without FL in aspects of FBG, HbAle, TC, LDL-C and age, stature （P 〉 0.05）, but significant difference did show between them in aspects of CP （4.09 ±2.40 μg/L vs 2.47 ± 1. 74 μg/L） , 2h CP （6.38 ± 5.46 μg/L vs 4.35 ± 2.92 μg/L） , TG （2.81 ±2.33 mmol/L vs 1.93 ± 1.92 mmol/L） , HDL-C （1.07±0.06 mmol/L vs 1. 19 ±0.32 mmol/L） as well as in body weight （73.4 ±11.7 kgvs61.4±10.1 kg） and BMI （26.0 ±3.67 vs22.8 ±3.23）, respectively （P 〈0.05 or P 〈0. 01 ）. Moreover, phlegm-dampness type was more liable to appear in DM2 patients complicated FL. Conclusions Obesity, insulin resistance and lipid metabolism disorder are the chief risk factors in DM2 patients complicated with FL and phlegm-dampness is the chief pathogenesis.