2型糖尿病伴非酒精性脂肪肝与胰岛素抵抗及血脂异常的研究

目的:探讨2型糖尿病(T2DM)伴非酒精性脂肪肝(NAFLD)与胰岛素抵抗(IR)及血脂异常的关系。方法:随机选取T2DM患者68例,按是否并发NAFLD分为脂肪肝组38例和非脂肪肝组30例,测定两组患者的甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)及餐后2h血浆胰岛素(2hIns),计算并比较两组之间的体重指数(BMI)、腰臀比(WHR)以及胰岛素抵抗指数(HOMA-IR)。同时检测肝功能。结果:脂肪肝组TG、LDL-C、Fins、2hIns、BMI、WHR、HOMA-IR、ALT、AST的平均水平均显著高于非脂肪肝组,而HDL-C则显著低于非脂肪肝组。两组FPG、2hPG及HbA1c水平则无显著差异。结论:T2DM伴NAFLD患者存在着明显的胰岛素抵抗及脂质代谢异常。

Relationship between insulin resistance and dyslipidemia in type 2 diabetes mellitus associated with nonalcoholic fatty liver

Objective:To explore the relationship between insulin resistance(IR) and dyslipidemia in type 2 diabetes mellitus(T2DM) associated with nonalcoholic fatty liver(NAFLD).Methods:Sixty-eight patients with T2DM were randomly divided into fatty liver group(DF group) with 38 cases and non-fatty liver group(NDF group) with 30 cases.Blood lipid,blood glucose,fasting and 2-hour serum insulin,and liver and kidney function were detected.Body weight index(BMI),waist-hip ratio(WHR) and insulin resistance index(HOMA-IR) were calculated and compared between the two groups.Results: The average levels of TG,LDL-C,Fins,2hIns,BMI,WHR,HOMA-IR,ALT and AST in fatty liver group were significantly higher than those in non-fatty liver group,while the level of HDL-C was significant lower than that in non-fatty liver group.But there were no significant difference for FPG,2hPG and HbA1c between the two groups.Conclusion:T2DM patients complicated with NAFLD have more obvious insulin resistance and lipid metabolism.