2型糖尿病合并非酒精性脂肪肝患者动脉硬化危险因素的分析

目的分析2型糖尿病合并非酒精性脂肪肝患者颈动脉内膜中层厚度(IMT)与细胞间黏附分子1(ICAM-1)和C反应蛋白(CRP)的关系。方法选择2型糖尿病患者85例,按是否合并非酒精性脂肪肝分为合并组41例、糖尿病组44例,检测血脂、ICAM 1、CRP及IMT和胰岛素抵抗指数(HOMA-IR)进行分析。结果与糖尿病组比较,合并组患者LDL-C、TG、HOMA-IR、CRP和IMT明显升高(P<0.05,P<0.01),2组ICAM-1比较,差异无统计学意义(P>0.05)。ICAM-1和CRP与IMT呈正相关;HOMA-IR、LDL-C、CRP和TG是IMT的危险因素。结论 2型糖尿病合并非酒精性脂肪肝更易出现大血管病变;血清CRP水平升高与动脉粥样硬化的形成相关。

Analysis on risk factors of atherosclerosis in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease

Objective To investigate the relationship of intima-media thickness(IMT) of carotid artery with intercellular adhesion molecule-1(ICAM-1) and C-reactive protein(CRP) in patients with type 2 diabetes mellitus(T2DM) and non-alcoholic fatty liver disease.Methods 85 cases of T2DM were divided into two groups:with non-alcoholic fatty liver disease(NAFLD,n = 41) and no non-alcoholic fatty liver disease(NNAFLD,n = 44).The serum levels of ICAM-1,CRP,IMT and HOMA-IR were detected.A multiple stepwise regression analysis was used with IMT as the dependent variable.Results Compared with NNAFLD group,TG,LDL-C,CRP,IMT and HOMA-IR were higher in the NAFLD group.In NAFLD group HOMA-IR,LDL-C,CRP and TG were correlated positively with IMT.Conclusions T2DM individuals with NAFLD are characterized by both metabolic disorder and insulin resistance.Increased IMT and high serum CRP level are related to development and progression of atherosclerosis in T2DM patients with NAFLD.