2型糖尿病患者非酒精性脂肪肝与亚临床炎症因子的关系  

Relationship between Nonalcoholic Fatty Liver Disease and Subclinical Inflammatory Factors in Patients with Type 2 Diabetes

作　　者：宋旭臣[1] 赵伟[1] 王利霞[1] 崔姗姗[1] 李美[1] 张宏[1] 

机构地区：[1]天津医科大学代谢病医院,卫生部及天津市激素与发育重点实验室,300070

出　　处：《天津医药》2010年第10期859-861,共3页Tianjin Medical Journal

摘　　要：目的:探讨2型糖尿病(T2DM)患者非酒精性脂肪肝(NAFLD)与血清超敏C反应蛋白(hs-CRP)、外周血白细胞(WBC)计数、血浆纤维蛋白原(FIB)水平的关系。方法:我院住院的T2DM患者430例,由一名影像医师盲态对所有受试对象进行腹部B超检查,根据检查结果分为NAFLD组和对照组。用免疫浊度法测定hs-CRP,透射比浊法测定FIB,用Coulter血液计数仪检测WBC。结果:NAFLD组体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)、hs-CRP、WBC、FIB显著高于对照组,高密度脂蛋白胆固醇(HDL-C)明显降低(均P<0.05),调整了年龄、性别、DM病程、吸烟、血压、血脂、BMI、糖化血红蛋白A1c(HbA1c)后,hs-CRP仍为T2DM患者发生NAFLD的危险因素(OR=1.839,95%CI:1.384～2.444)。结论:亚临床炎症因子,尤其血清hs-CRP与T2DM患者NAFLD的发生密切相关,改善T2DM患者的炎症状态将有助于NAFLD的防治。Objective：To investigate the correlation of the levels of high sensitivity reactive protein C（hs-CRP）,white blood cell（WBC） and fibrinogen（FIB） in nonalcoholic fatty liver disease（NAFLD） with type 2 diabetes.Methods：The abdominal ultrasound images of 430 patients with type 2 diabetes were performed by a physician blinded to all subjects.The patients were divided into two groups based on with/without NAFLD.The levels of hs-CRP and FIB were detected by immune turbidimetric method and nephelometry respectively.The level of WBC was detected by Coulter blood counter.Results：Compared to control group,body mass index（BMI）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,triglyceride（TG）,hs-CRP,WBC and FIB increased obviously in NAFLD group,and the level of high-density lipoprotein cholesterol decreased obviously（P 0.05）.After adjusting the age,gender,the ascend duration of diabetes,smoking,blood pressure,lipid,BMI and HbA1c,the level of hs-CRP was the risk factor of NAFLD（OR=1.839,95%CI：1.384-2.444）.Conclusion：The subclinical inflammatory factors,especially the level of hs-CRP,are closely related with NAFLD.Improving inflammation in condition of the patients with type 2 diabetes will help prevention and treatment of NAFLD.

关 键 词：糖尿病 2型 脂肪肝 胰岛素抗药性 C反应蛋白质 白细胞 纤维蛋白原 LOGISTIC模型 

分 类 号：R575.5[医药卫生—消化系统]