2型糖尿病合并非酒精性脂肪性肝病患者颈动脉内膜中层厚度改变及相关因素的分析

目的 以颈动脉内膜中层厚度（IMT）作为动脉粥样硬化的评估指标,探讨非酒精性脂肪肝（NAFLD）和2型糖尿病（T2DM）与颈动脉病变的关系.方法 患者165例,分为对照组、NAFLD组、T2DM组、T2DM合并NAFLD组,测量各组生化指标、彩超测量颈动脉内膜中层厚度（IMT）.采用稳态模型法评估基础状态胰岛素抵抗.结果 ①各组在性别、年龄、血压上差异无统计学意义（P＞0.05）.②NAFLD组TG、TC、LDL-C较对照组及T2DM组升高（P＜0.05）.③T2DM组FBG、HbA1C、HOMA-IR、较对照组和NAFLD组升高（P＜0.05）.④T2DM组和NAFLD组HOMA-IR、TC、TG、LDL、BMI和IMT较对照组升高（P＜0.05）.⑤T2DM合并NAFLD组的FBG、TC、TG、LDL-C、HOMA-IR、BMI和IMT较其他三组升高（P＜0.05）.结论 T2DM、NAFLD与血脂异常、肥胖密切相关,T2DM合并NAFLD时糖脂代谢紊乱更为明显.T2DM合并NAFLD患者颈动脉IMT厚度明显增高,可作为此类人群早期发现动脉粥样硬化的常规检测手段之一.

Corotid intima-media thickness change in patients with type 2 diabets mellitus combined with non-alcoholic fatty liver disease and analysis of the relevent factors

Objective Measuring intima-media thickness（IMT） in the carotid as evaluation parameters of atheroselerosis, to explore the relationship between non-alcoholic fatty lever disease（NAFLD）and carotid atherosclerosis in hospitalized type 2 diabetics. Methods Select 165 patients, dividing into control group, NAFLD, T2DM group and T2DM with NAFLD group. Measure each biochemical indicators,and carotid intima-media thickness （IMT） using the steady-state model method based state assessment of insulin resistance. Results ①Between groups, there was no statistically significant difference in gender, age, and blood pressure. （P 〉0. 05 ）. ②NAFLD group TG, TC, LDL - C higher than that of control group and T2DM group. （P 〈0. 05）. ③T2DM group FBG, HbAIC, HOMA IR, higher than the control group and NAFLD group. （P 〈 0. 05）. ④T2DM group and NAFLD TC, TG,LDL-C, BMI and IMT is higher than the control group（P 〈0. 05）. ⑤T2DM combined NAFLD group of FBG, TC, TG, LDL - C, HO- MA-IR, BMI and IMT is higher than the other three groups. （P〈0.05）. Conclusion T2DM, NAFLD, closely associated with dyslipidemia, obesity, T2DM with NAFLD glucolipid metabolic disorder is more apparent. T2DM with NAFLD patients significantly higher, the thickness of the carotid artery IMT can be used as such people in the early detection of atherosclerosis one of conventional detection methods.