非酒精性脂肪肝和2型糖尿病与颈动脉病变的关系

目的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。方法按是否有T2DM和NAFLD分为4组:对照组、NAFLD组、T2DM组、T2DM合并NAFLD组,观察各组临床及生化特征、颈动脉内-中膜厚度(IMT)以及超声分型,并对出现的颈动脉斑块形态、特点和颈动脉斑块积分进行分析。结果 T2DM合并NAFLD组的HOMA胰岛素抵抗指数高于其他三组;单纯T2DM组和NAFLD组HOMA-IR、TC、TG、LDL-C和BMI高于对照组,HDL-C低于对照组。T2DM合并NAFLD组IMT与其他三组比较,差异显著(P<0.05);T2DM组、NAFLD组IMT也大于对照组(P<0.05)。颈动脉硬化超声分型各组之间构成比的比较有差异。T2DM合并NAFLD组不稳定斑块形成高于T2DM组、NAFLD组,颈动脉斑块积分也较T2DM组、NAFLD组增多。结论NAFLD、T2DM与胰岛素抵抗、血脂异常、肥胖密切相关,易引起动脉粥样硬化,T2DM合并NAFLD与动脉粥样硬化斑块不稳定性和斑块发生程度之间有一定关联。

Relationship between non-alcoholic fatty liver disease/type 2 diabetes and carotid artery disease

Objective To investigate the relationship between non-alcoholic fatty liver disease(NAFLD)/type 2 diabetes(T2DM) and carotid artery disease.Methods Patients met the inclusion criterias were divided into control group,NAFLD group,T2DM group and T2DM concurrence with NAFLD group according to whether they had NAFLD and T2DM.The clinical and biochemical features,carotid intima-media thickness(IMT) and ultrasound types were observed and the carotid artery plaque morphology,features and carotid artery plaque scores were analyzed.Results HOMA-IR in T2DM concurrence with NAFLD group was higher than that in other three groups.HOMA-IR,TC,TG,LDL-C and BMI in the NAFLD group and T2DM group were respectively higher than those in control group,while HDL-C in the two groups was lower than that in control group.There was great difference of IMT value among T2DM concurrence with NAFLD group and other three groups(P<0.05),IMT value in NAFLD group,T2DM group was greater than that in control group(P<0.05).There was also difference among the four groups about proportions of ultrasonic classification of carotid atherosclerosis.The unstable plaque and carotid plaque scores in the T2DM concurrence with NAFLD group were both higher than those in NAFLD group and T2DM group.Conclusion NAFLD and T2DM have close relationship with insulin resistance,dyslipidemia and obesity.T2DM concurrence with NAFLD have some relevances with atherosclerotic plaque instability and the severity of plaque.