老年2型糖尿病并发非酒精性脂肪肝与颈动脉粥样硬化的关系

目的 探讨老年2型糖尿病(T2DM)患者并发非酒精性脂肪肝(NAFLD)与颈动脉粥样硬化的关系.方法 将150例老年T2DM患者分为合并NAFLD 76例(T2DM+NAFLD组)与未合并NAFLD74例(T2DM组),比较两组各项生物化学指标、颈动脉内膜中层厚度(CIMT),观察斑块形成和动脉狭窄情况.结果 老年T2DM+NAFLD组体质量指数(BMI)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、三酰甘油(TG)、空腹胰岛素(FINS)、空腹C肽(FCP)、餐后2hC肽(2hCP)、胰岛素抵抗指教(HOMA-IR)、CIMT明显高于老年T2DM组(P＜0.05).老年T2DM+NAFLD组高密度脂蛋白(HDL)低于老年T2DM组(P＜0.05).老年T2DM+NAFLD组颈动脉粥样硬化患病率、斑块形成率、动脉狭窄率均高于老年T2DM组(P＜0.05).CIMT与糖尿病病程、年龄、TG、总胆固醇(TC)、空腹血糖(FPG)、餐后2h血糖(2hPG)、FINS、餐后2h胰岛素( 2bINS)相关.结论 老年T2DM并发NAFLD与血脂代谢紊乱、胰岛素抵抗有关,且易于发生颈动脉粥样硬化.

Relationship between aged type 2 diabetes complicating nonalcoholic fatty liver and carotid artery atherosclerosis

Objective To investigate the relationship between aged type 2 diabetes mellitus(T2DM) complicating nonalcoholic fatty liver disease(NAFLD) and carotid artery atherosclerosis.Methods 150 cases of aged T2DM were divided into the DM + NAFLD group(76 cases) and the DM group(74 cases) without NAFLD.The biochemical parameters and carotid intima-media thickness(CIMT) were compared between the two groups.Their atherosclerotic plaque and arterial stenosis were observed.Results The level of BMI,ALT,AST,TG,FINS,FCP,2hCP,HOMA-IR and CIMT in the DM+NAFLD group were higher than those in the DM group(P<0.05).The level of HDL in the DM+NAFLD group was lower than that in the DM group(P<0.05).The incidence rate of carotid artery atherosclerosis,formation rate of atherosclerotic plaque and arterial stenosis rate in the DM+NAFLD were higher than those in the DM group(P<0.05).CIMT was correlated with the DM duration,age,TG,TC,fasting-plasma glucose(FPG),2-h postprandial glucose(2hPG),FINS,2-h postprandial insulin(2hINS).Conclusion Aged T2DM complicating NAFLD is related with dyslipidemia and insulin resistance,and easy to occur carotid artery atherosclerosis.