2型糖尿病患者非酒精性脂肪肝与颈动脉粥样硬化关系的研究

目的以颈动脉内膜中层厚度(IMT)为主要研究参数,探讨新诊断2型糖尿病(T2DM)患者非酒精性脂肪肝病(NAFLD)与颈动脉粥样硬化之间的关系。方法观察对象分为三组:对照组:39例健康对照者;糖尿病无NAFLD组:33例单纯性新诊断2型糖尿病者;糖尿病NAFLD组:38例新诊断2型糖尿病合并NAFLD者,比较三组IMT,并将IMT与HOMA-IR、血脂等指标进行相关性分析。结果与对照组比较,新诊断T2DM患者存在颈动脉内膜增厚(1.12±0.11)mmvs(0.81±0.12)mm,P0.05)],当伴有NAFLD时其颈动脉内膜增厚更加明显及颈动脉粥样斑块形成增多(1.35±0.13)mmvs(1.12±0.11)mm,P0.05)]。在T2DM患者中,IMT与HOMA-IR呈显著正相关(r=0.485,P0.05)。结论新诊断T2DM患者存在颈动脉内膜增厚,当伴有NAFLD时,其颈动脉内膜更加增厚且颈动脉斑块形成增多。

Relationship between NAFLD and Carotid Artery Atherosclerosis in Type 2 Diabetes

Objective To investigate the relationship between non-alcoholic fatty liver disease and carotid artery atherosclerosis in newly diagnosed type 2 diabetes.Methods We divided 110 cases into three groups by blood glucose level and ultrasonic examination results：control group （39 cases with normal blood glucose level）,T2DM without NAFLD group （33 cases newly diagnosed as type 2 diabetes without NAFLD and T2DM with NAFLD group （38 cases newly diagnosed as type 2 diabetes with NAFLD）.Carotid artery intima-media thicknes （IMT） was determined by colorful Doppler ultrasonography.Results Compared with the control group,the T2DM with or without NAFLD groups showed higher mean IMT（1.12±0.11）mm vs（0.81±0.12）mm（P 0.05）.The IMT in the T2DM with NAFLD group was higher than that in the T2DM without NAFLD group and increased carotid artery atheromatous plaque（1.35±0.13）mm vs（1.12±0.11）mm（P0.05）.The IMT was positively associated with HOMA-IR（r=0.485,P0.05）.Conclusion Newly diagnosed type 2 diabetes shows increased carotid artery intima-media thickness,and the IMT in newly diagnosed type 2 diabetes with NAFLD is more severe than that in T2DM without NAFLD.