新诊断2型糖尿病合并非酒精性脂肪肝患者下肢动脉粥样硬化的临床分析  

Clinical Investigation of Lower-extremity Arterial Disease in Patients with Newly Diagnosed Type 2 Diabetes Mellitus Combined with Nonalcoholic Fatty Liver Disease

作　　者：张晓菲[1] 陈燕铭[1,2,3] 孙艳[1] 王曼曼[1] 何圣清[1] 舒冏[1] 张国超[1] 曾龙驿[1] 

机构地区：[1]中山大学附属第三医院内分泌科,广东广州510630 [2]中山大学附属第三医院体检中心,广东广州510630 [3]中山大学附属第三医院特诊中心,广东广州510630

出　　处：《中山大学学报（医学科学版）》2010年第1期134-137,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金(9151008901000092)

摘　　要：【目的】探讨新诊断2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者发生下肢动脉粥样硬化的临床特点及危险因素。【方法】对151例新诊断2型糖尿病住院患者进行回顾性研究。根据是否合并NAFLD分为A组(合并NAFLD,92例)和B组(无NAFLD,59例),比较两组患者胰岛素抵抗、脂代谢紊乱、下肢动脉粥样硬化程度的差异。【结果】92例(60.93%)新诊断住院2型糖尿病患者伴NAFLD,A组有较高的体质量指数、甘油三酯、血尿酸、胰岛素抵抗指数、空腹胰岛素和C肽、餐后2h胰岛素和C肽水平,及较低的高密度脂蛋白胆固醇和胰岛素敏感指数水平;与B组比较,差异有统计学意义(P<0.05);两组血糖则无明显差别(P>0.05)。101例(66.89%)新诊断住院2型糖尿病患者伴不同程度的下肢动脉血管病变,A组下肢动脉粥样硬化较B组明显增加。【结论】新诊断2型糖尿病患者脂肪肝及下肢血管动脉硬化都较高,合并NAFLD的患者发生下肢动脉硬化比不合并NAFLD的患者明显升高,而且下肢动脉硬化病变也更严重。【Objective】 To investigate the clinical characteristics and risk factors of lower-extremity arterial disease in the patients with newly diagnosed type 2 diabetes mellitus combined with nonalcoholic fatty liver disease （NAFLD）.【Methods】 One hundred fifty-one patients were investigated respectively.The patients were divided into two groups （NAFLD-Group and non- NAFLD group） by liver ultrasonography and disease history,then their clinical data were collected and compared in order to find the differences of biochemical indicators and the morbidity of lower-extremity arterial disease between two groups.【Results】 Ninety-two cases （60.93%） were complicated with NAFLD.NAFLD group had higher levels of fast insulin and C peptide level,postprandial insulin and C peptide level,uric acid,body mass index （BMI）,homeostasis model assessment （HOMA-IR） and lower level of high-density lipoprotein cholesterol and insulin sensitive index than those of without NAFLD （P 0.05）.One hundred and one cases（66.89%） were complicated with lower-extremity arterial disease.The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group （75% vs.54.24% ,P 0.01）.【Conclusion】 Both lower-extremity arterial disease and NAFLD are common complicated with type 2 diabetes.The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group.

关 键 词：2型糖尿病 非酒精性脂肪肝 下肢动脉粥样硬化 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]