2型糖尿病患者非酒精性脂肪肝患病率及其相关危险因素研究

目的探讨2型糖尿病患者非酒精性脂肪肝（NAFLD）的患病率及其相关危险因素。方法选取2012年1—12月2型糖尿病患者210例，与同期健康体检者212例（健康对照组，A组），根据有无高尿酸血症将2型糖尿病患者分为糖尿病组（B组，62例），糖尿病并发高尿酸血症组（C组，148例）。测定三组体质量指数（BMI）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、血尿酸（UA）、空腹血糖（FPG）、空腹胰岛素（FiNs）或C肽、丙氨酸氨基转移酶（AIJT）、天门冬氨酸氨基转移酶（AST）、同型半胱氨酸（Hcy），采用B型超声定性测定脂肪肝的有无，稳态模型评估法（HOMA）评估胰岛素抵抗指数（HOMA．IR），比较各组NAFLD惠病率及生化指标。结果B、C组NAFLD患病率均显著高于A组；A组血UA、FINs或C肽、TG、BMI、Hcy、HOMA．IR显著低于其他两组，而HDL显著高于其他两组，差异有统计学意义（火O．05）；B组及C组TC、ALT、LDL显著高于A组，C组AST显著高于其他两组，差异有统计学意义（P〈0．05）。Logistic回归结果显示，BMI、HOMA—IR、TG、血UA是NAFLD的独立危险因素f比值比（OR）=1．204、1．335、1．452和1．006．P〈O．051。结论2型糖尿病患者NAFLD患病率明显升高，尤其是合并高尿酸血症：HOMA—IR、BMI、UA、TG是2型糖尿病患者发生NAFLD的独立危险因素。

Study on the prevalence rate of type 2 diabetic patients with non-alcoholic fatty liver disease and the associated risk factors

Objective To research the prevalence rate of type 2 diabetic patients with non-alcoholic fatty liver disease （NAFLD） and associated risk factors. Methods A total of 210 cases of type 2 diabetes mellitus（T2DM） from January to December 2012 were selected and 212 healthy cases（healthy control group,group A） underwent physical examination at the same period were chosen. According to the presence of hyperuricemia, the patients with T2DM were divided into diabetes mellitus group （group B, n=62） and the group of diabetes mellitus along with hyperuricemia （group C, n=148 ）.The body mass index （BMI）, triglyceride （TG）, total cholesterol （TC）, high density lipoprotein （HDL）, low density ]ipoprotein （LDL）, blood uric acid （ UA ）, fasting blooJ- glucose （FPG）, fasting insulin （FINs） or C-peptide, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, homocys- teine （Hcy） in the three groups were determined. Type-B ultrasound was adopted to examine whether fatty liver was existed or not. Homeostasis model assessment （HOMA） was used to assess insulin resistance index （HOMA-IR）. The prevalence rate of NAFLD and biochemical index in the groups were compared. Results The prevalence rate of NAFLD in group B and group C was higher than that in group A significantly. The UA, FINs （or C-peptide）, TG, BMI, Hcy and HOMA-IR in group A were significantly lower than those in the other two groups ,while HDL in group A was significantly higher than that in the other two groups ,and the dif- ference had statistical significance （P〈0.05）. The TC, ALT, LDL in group B and group C were obviously higher than those in the group A, and the AST in gwup C was significantly higher than that in the other two groups, and the difference had statistical sig nificance （P〈0.05）. Logistic regression results showed that HOMA-IR,BMI,blood UA,TG were independent risk factors to NAFLD odd ratio（OR）=1.204, !.335,1.452 and 1.006,P〈0.05]. Conclusion Patients with T2DM have significantly higher prevalence rate of NAFLD, especially those with hyperuricemia;HOMA-IR, BMI, UA and TG are the independent risk factors of T2DM patients to NAFLD.