2型糖尿病合并非酒精性脂肪肝影响因素探讨

目的：探讨2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）的影响因素.方法：收集T2DM患者175例,根据有无合并NAFLD分为合并NAFLD组（A组）及不合并NAFLD组（B组）.分别测定患者身高、体重、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、糖化血红蛋白（HbAlc）、空腹血糖（FBG）、餐后2h血糖（PBG2H）、血清铁蛋白（SF）及空腹胰岛素（FINS）,并根据身高、体重计算体质指数（BMI）,根据空腹血糖及空腹胰岛素计算胰岛素抵抗指数（HOMA-IR）.结果：A组TG、LDL-C、SF、FINS、HOMA-IR均较B组升高,差异有统计学意义（P＜0.05）.以是否合并NAFLD为因变量,以TG、LDL-C、SF、FINS、HOMA-IR为自变量,行二分类逐步Logistic回归分析.进入回归方程的自变量为FINS、TG、OR分别为1.039,1.75.结论：T2DM合并NAFLD患者高胰岛素血症及胰岛素抵抗更明显.T2DM合并NAFLD患者TG、LDL-C、SF水平较不合并NAFLD患者升高.FINS、TG水平的升高可能增加T2DM合并NAFLD的患病风险.

INFLUENCE FACTORS OF TYPE 2 DIABETES WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Objective：To investigate the influence factors of type 2 diabetes mellitus （T2DM） with non-alcoholic fatty liver disease （NAFLD）.Methods：A total of 175 T2DM patients were enrolled and divided into two groups,based on whether they were complicated with NAFLD [A （complicated with NAFLD）,B （not complicated with NAFLD）].The level of height,weight,total cholesterol （TC）,triglyeeride （TG）,high density lipoprotein （HDL-C）,low density lipoprotein （LDL-C）,hemoglobin （HbAlc）,fasting blood-glucose （FBG）,2h postprandial blood-glucose （PBG2H）,serum ferritin （SF） and fasting insulin （FINS） were measured.Body mass index （BMI） and index of insulin resistance （HOMA-IR） were calculated.Results：The levels of TG,LDL-C,SF,FINs,HOMA-IR in group A were significantly higher than those in group B （P 〈0.05）.Independent variable was induced in regression model were FINS,TG,logistic regression analysis showed the value of OR was 1.039,1.75.Conclusion：Hyperinsulinemia and insulin resistancein type 2 diabetes mellitus with non-alcoholic fatty liver disease was more obvious.The levels of TG,LDL-C,SF was significantly higher in T2DM with NAFLD than in T2DM without NAFLD.The results indicate that FINS and TG are the risk factors for T2DM complicated with NAFLD in our study.