2型糖尿病并发非酒精性脂肪肝的危险因素及其与糖尿病大血管病变的相关性研究

目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的危险因素,及其与糖尿病大血管病变的相关性。方法选取住院T2DM患者214例,根据肝脏B超检查结果分为NAFLD组和非NAFLD组,回顾性分析了两组患者的临床指标和大血管病变发生情况,采用Logistic多元回归分析筛选危险因素。结果有116例住院T2DM患者合并NAFLD(54.2%),98例未合并NAFLD(45.8%)。NAFLD组较非NAFLD组体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、血三酰甘油(TG)、γ-谷氨酰转移酶(GGT)、丙氨酸氨基转移酶(ALT)显著增高(P<0.05);且大血管病变发生率显著高于非NAFLD组(P<0.05)。Logistic多元回归分析显示,SBP、TG、GGT是糖尿病发生NAFLD的独立危险因素(P<0.05);NAFLD、年龄、总胆固醇(TC)水平是糖尿病发生大血管病变的独立危险因素(P<0.01)。结论 SBP、TG、GGT是T2DM并NAFLD的独立危险因素,NAFLD与糖尿病大血管病变高风险密切相关。

Clinical Analysis of Non-Alcoholic Fatty Liver Disease and Its Association with Diabetic Macroangiopathy in Type 2 Diabetic Patients

Objective To explore the risk factors of non-alcoholic fatty liver disease(NAFLD)and its association with macroangiopathy in type 2 diabetic patients(T2DM). Methods 214 in-patients with T2DM were divided into NAFLD group and non-NAFLD group according to the results of ultrasonic images.Clinical indicators and macroangiopathy were retrospectively analyzed in the two groups.Logistic multiple regression analysis was used to analyze the risk factors. Results 116 cases(54.2%)had NAFLD and 98 cases(45.8%)had no NAFLD in 214 T2DM in-patients.Compared with diabetic patients without NAFLD,the patients with NAFLD had significantly higher levels of body mass index,systolic pressure,diastolic pressure,triglyceride and γ-glutamyltransferasev and alanine transarninase(P<0.05).In NAFLD group,the incidence of macroangiopathy was significantly higher than in non-NAFLD group(P<0.05).Logistic regression analysis showed that SBP,TG and GGT were independent risk factors for NAFLD(P<0.05).NAFLD,age and cholesterol levels were independent risk factors for macroangiopathy(P<0.01). Conclusion SBP,TG and GGT were independent risk factors for NAFLD.NAFLD is closely related to the high incidence of diabetic macroangiopathy.