辽宁省体检人群2型糖尿病合并非酒精性脂肪肝病调查研究

目的:探讨2型糖尿病(T2DM)患者合并非酒精性脂肪性肝病(NAFLD)的危险因素。方法:分析1800名体检者体检资料,其中T2DM患者360例(20%),再分为NAFLD(T2DM+NAFLD)组(280例)和单纯T2DM(对照)组,对两组患者体重指数(BMI)、腰臀比(WHR)、空腹血糖(FBG)、血脂、血清丙氨酸转氨酶(ALT)、胰岛素抵抗指数(HOMA-IR)以及合并症进行分析。结果:T2DM主要分布在中青年人群。同时有T2DM和NAFLD者的患者,男性(180例)比女性(80例)明显增加(P0.001),检出高峰在中、老年人群。NAFLD组患者BMI(27.1±2.1)kg/m2∶(22.9±2.0)kg/m2]、WHR(1.4±0.1)∶(0.9±0.3)]、FBG(10.1±2.2)mmol/L∶(8.9±2.3)mmol/L]、总胆固醇TC,(6.3±1.5)mmol/L∶(5.8±1.6)mmol/L]、ALT(59.6±33.1U/L)∶(27.4±11.7)U/L]、HOMA-IR(5.1±1.3)∶(3.4±1.2)]均明显高于对照组(P均0.05)。NAFLD组患者合并肥胖症(53.1%∶27.9%)、中心性肥胖(80.3%∶44.7%)、高血压(58.9%∶42.5%)均显著高于对照组(P均0.05)。Logistic逐步回归分析显示HOMA-IR(OR=2.58,P0.01)、WHR(OR=2.66,P0.01)、BMI(OR=1.28,P0.05)是NAFLD的危险因素。结论:2型糖尿病合并非酒精性肝病患病率主要见于中、老年人,男性高于女性,糖、脂代谢障碍严重,其独立危险因素是胰岛素抵抗、中心性肥胖和体重指数。

Prevalence study of type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease in Shenyang city

Objective： To studying the risk factors of patients with type 2 diabetes mellitus （T2DM） complicated with non-alcoholic fatty liver disease （NAFLD）. Methods： Tile physical examination data of 1800 cases for T2DM was ana- lyzed. In which there were 360 （20%） patients with T2DM, they were divided into NAFLD （T2DM complicated with NAFLD） group （280 cases） and pureT2DM （ton＇troD group （80 cases）. Analysis was conducted on the body mass index （BMI）, waist hip ratio （WHR）. fasting blood glucose （FBG）, lipid, alanine transaminasc （ALT）, homeostasis model assessment insulin resistance （HOMA IR） and complications in the two groups. Results： The peak age of -F2DM was 40-59 years old. The peak age of NAFLD was in mid-old persons, its prevalence in men （180 cases） was significantly higher than that of women （180 cases, P〈0. 001）, In NAFLD group, BMI （27.1±2.1） kg/m2 vs. （22.9±2.0） kg/m2], WHR （1.4±0.1） vs. （0.9±0.3）], FBG （10.1±2.2） mmol/Lvs. （8.9±2.3） mmol/ L], total cholesterolTC, （6.3±1.5） mmol/Lvs. （5.8±1.6） mmol/LJ, ALT （59.6±33.1U/L） vs. （27.4± 11.7） U/L], HOMA--IR （5. 1±1.3） vs. （3.4±1.2）] were significantly higher than those of the control group （P〈0.05 all） . In NAFLD group, the patients complicated with obesity （53. 1% vs. 27.9%）, central obesity （80.3% vs. 44.7%） and hypertension （58.9% vs. 42.5%） were significantly higher than those in control group （P〈0.05 all）. Logistic stepwise regression analysis indicated that HOMA--IR （OR=2.58, P〈0.01）, WHR （OR= 2.66, P〈0.01） and BMI （OR=1.28, P〈0.05）. Conclusion： The incidence rate of type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease increases along with age, and itrs higher in men than that in women. The risk factors of this disease are body insulin resistance, central obesity and mass index.