2型糖尿病患者非酒精性脂肪肝与微血管病变关系的研究  

Non-alcoholic fatty liver disease is associated with chronic kidney disease and diabetic retinopathy in type 2 diabetic patients

作　　者：吴景程[1] 李晓华[1] 彭永德[1] 程群[1] 

机构地区：[1]上海交通大学附属第一人民医院内分泌代谢科,上海200080

出　　处：《中国实用内科杂志》2010年第1期41-43,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(30700381);上海市科委引领计划项目(74119638)

摘　　要：目的探讨2型糖尿病(T2DM)患者中非酒精性脂肪肝(NAFLD)与慢性肾脏疾病(CKD)及糖尿病视网膜病变(DR)的关系。方法收集2008年5月至2009年7月上海交通大学附属第一人民医院内分泌代谢科448例T2DM患者的临床资料,按是否合并NAFLD分组,比较两组间CKD和DR的发生率及其与NAFLD的联系。结果(1)448例T2DM患者中NAFLD合并率为59.4%。(2)与无NAFLD组相比,NAFLD组尿白蛋白/肌酐比值(UACR)及CKD和DR的发病率明显升高(P<0.01)。(3)Logistic回归分析显示,NAFLD是T2DM患者发生CKD和DR的独立危险因素(OR=1.9,P<0.05;OR=2.8,P<0.01)。结论T2DM患者中NAFLD与CKD和DR密切相关,提示通过早期诊断和干预NAFLD可预防微血管并发症。Objective To investigate the relationship of non-alcoholic fatty liver disease （NAFLD） with chronic kidney disease（CKD） and diabetic retinopathy （DR） in type 2 diabetic patients. Methods Prevalenees of CKD and DR were assessed in 448 type 2 diabetic patients ,who were divided into two groups by the presence of NAFLD. Results （ 1 ） The prevalence of NAFLD was 59.4% in type 2 diabetic patients. （2） NAFLD patients had remarkably（ P 〈 0. 01 ） higher urinary albumin/creatinine ratio （ UACR ） and prevalences of CKD （ 30. 8 vs 18. 1% ） and DR（35.7 vs 21.4% ） than their counterparts without NAFLD. （3）Logistic regression analysis showed that NAFLD was associated with increased incidences of CKD（ OR = 1.9 ,P 〈0. 05） and DR（ OR = 2. 8, P 〈 0. 01 ） independent of age, sex, diabetes duration, BMI, hypertension, smoking, HbA1 c and serum lipids. Conclusion NAFLD is associated with increased prevalences of CKD and DR in type 2 diabetic patients. Early i- dentification and intervention of NAFLD can help to prevent diabetic microvascular complications.

关 键 词：2型糖尿病 非酒精性脂肪肝病 慢性肾脏疾病 糖尿病视网膜病变 

分 类 号：R5[医药卫生—内科学]