血脂指标比值对2型糖尿病患者发生非酒精性脂肪肝的预测价值

目的 分析2型糖尿病(T2DM)患者各项血脂指标比值对非酒精性脂肪肝(NAFLD)的预测价值.方法 采取方便取样方法抽取住院T2DM患者414例,根据是否合并NAFLD,分为T2DM NAFLD组208名和T2DM非NAFLD组206名.分别测量身高、体质量、腰围、血压;检测三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸及糖化血红蛋白(HbA1C),计算体质量指数(BMI)及非高密度脂蛋白胆固醇(non-HDL-C).结果 以是否发生NAFLD为因变量,以单因素分析有意义的病程、腰围、体质量、BMI、舒张压、TG、HDL-C、TC/HDL-C、LDL-C/HDL-C、non-HDL-C、non-HDL-C/HDL-C、尿酸为自变量,进行Logistic回归分析,则BMI(OR=1.239,95%CI=(1.139~1.348))、TC/HDL-C(OR=1.209,95%CI=(1.036~1.412))、尿酸(OR=1.005,95%CI=(1.002~1.008))是T2DM患者发生NAFLD的独立危险因素;为探讨non-HDL-C和non-HDL-C/HDL-C与NAFLD的关系,将病程、腰围、体质量、BMI、舒张压、non-HDL-C、non-HDL-C/HDL-C、尿酸设为自变量,则BMI(OR=1.240,95%CI=(1.139~1.349))、non-HDL-C/HDL-C(OR=1.206,95%CI=(1.033~1.407))、尿酸(OR=1.005,95%CI=(1.002~1.008))是T2DM患者发生NAFLD的独立危险因素.结论 除了超体质量和高尿酸血症,在血脂比值指标中,TC/HDL-C是T2DM患者发生NAFLD的危险因素,non-HDL-C/HDL-C比non-HDL-C更能预测NAFLD的发生.

Value of serum lipid index ratio in the prediction of non-alcoholic fatty liver in the patients with type 2 diabetes

Objective To analyze the value of various serum lipid index ratios in the prediction of non-alcoholic fatty liver in the patients with type 2 diabetes( T2DM) .Methods By depending on whether or not they had complications of nonalcoholic fatty liver disease (NAFLD), 414 inpatients with type 2 diabetes were divided into 2 groups:the T2DM with alcoholic fatty liver disease group (n=208) and the T2DM with NAFLD group (n=206).Measurements of height, weight, waist circumstance, blood pressure, triglyceride ( TG) , total cholesterol ( TC) , low-density lipoprotein cholesterol ( LDL-C) , high-density lipoprotein cholesterol ( HDL-C) , hemoglobin and blood uric acid were made in all patients of the 2 groups, and body-mass index (BMI) and non high-density lipoprotein cholesterol, and body mass index and non-HDL-C were calculated as well.Results With NAFLD as variables, logistic regression was made on disease course, waist circumstance, weight, boss-mass index, diastolic pressure, TG, HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C, non-HDL-C/HDL-C.Detection results revealed that BMI〔(OR=1.239, 95%CI=(1.139, 1.348)〕, TC/HDL-C〔(OR=1.209,95%CI=(1.036, 1.412) 〕, and blood uric acid〔(OR=1.005, 95%CI=(1.002, 1.008)〕, were independent risk factors.To explore the associ-ation between non-HDL-C/non-HDL-C/HDL-C and NAFLD, the disease course, waist circumstance, weight, BMI, diastolic pressure, non-HDL-C, non-HDL-C/HDL-C and uric acid were set as independent variables.Detection results showed that BMI 〔( OR=1.240, 95%CI=(1.139, 1.349)〕, non-HDL-C/HDL-C〔(OR=1.206, 95%CI=(1.033, 1.407)〕and uric acid〔(OR=1.005, 95%CI=(1.002, 1.008)〕were independent risk factors of NAFLD in the patients with T2DM.Conclusion Besides overweight and high uric acid, TC/HDL-C was an important risk factor for NAFLD, and non-HDL-C/HDL-C could more accurately predict the occurrence of NAFLD.