2型糖尿病合并脂肪肝危险因素临床分析

目的:探讨2型糖尿病合并脂肪肝的患病率及相关因素．方法:对179例糖尿病患者进行临床、生化、胰岛素及肝脏彩超检查．结果:2型糖尿病合并脂肪肝的患病率为47．5％,该组的体重指数、空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)及甘油三酯高于于非脂肪肝组,2 h胰岛素无差异．以不同的体重指数分层,随着体重指数的增加,甘油三酯及HOMA-IR亦升高,而脂肪肝的患病率亦呈增加趋势．Logistic回归分析显示, HOMA-IR对于脂肪肝患病率的增加有显著意义(OR=1．582,P=0．023)．结论:影响2型糖尿病合并脂肪肝的因素很多,胰岛素抵抗可能为主要影响因素．体重指数可能通过高甘油三酯及胰岛素抵抗影响脂肪肝的形成．

Analysis of risk factors on nonalcoholic steatohepatitis in patients with type 2 diabetes

AIM: To study the prevalence and associated factor of fatty liver disease in type 2 diabetes patients. METHODS: Biochemical test, insulin monitoring and liver ultrasound examination were performed in 179 patients with type 2 diabetes. RESULTS: The prevalence rate of fatty liver disease was 47.5% in type 2 diabetes patients, whose body mass index (BMI), fasting plasma glucose, insulin, and triglycerides (TG) level as well as homeostasis assessment model of insulin resistance (HOMA-IR) index were higher than those in the patients without fatty liver. The level of TG and HOMA-IR were increased with the increase of BMI, and the occurrence rate of fatty liver disease was also elevated. Logistic analysis showed that HOMA-IR had marked correlation with the occurrence rate of fatty liver disease (OR = 1.582, P = 0.023). CONCLUSION: There are many influential factors for the occurrence of fatty liver disease in type 2 diabetes patients, and insulin resis- tance may be the main factor. The increase of body mass may affect the formation of fatty liver by TG and insulin resistance.