2型糖尿病合并非酒精性脂肪性肝病与代谢综合征及胰岛素抵抗的关系研究  

Relationship of Non- alcohol Fatty Liver Disease to Metabolic Syndrome and Insulin Resistance in Type 2 Diabetes Mellitus Patients

作　　者：许向红[1] 金星[1] 陈颖越[1] 马建华[1] 吴锦丹[1] 

机构地区：[1]南京医科大学附属南京医院内分泌科,江苏省南京市210006

出　　处：《中国全科医学》2013年第29期3419-3421,共3页Chinese General Practice

摘　　要：目的探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)与代谢综合征及胰岛素抵抗的关系。方法选择我院2010年1月—2011年12月住院T2DM患者1 105例,根据是否合并NAFLD分为T2DM不合并NAFLD组472例(A组),T2DM合并NAFLD组633例(B组),回顾性分析其临床资料。结果 B组的腰围、臀围、体质指数、舒张压、尿酸、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转肽酶、空腹C肽、餐后2 hC肽均高于A组(P<0.05),而年龄、尿素氮、肌酐、高密度脂蛋白胆固醇均低于A组(P<0.05),T2DM病程短于A组(P<0.05)。B组的代谢综合征、高脂血症发生率均高于A组(P<0.05)。Logistic回归分析结果显示,体质指数、三酰甘油、低密度脂蛋白胆固醇、丙氨酸氨基转移酶是T2DM患者发生NAFLD的独立危险因素,高密度脂蛋白胆固醇是保护因素。结论 NAFLD与肥胖、高脂血症及胰岛素抵抗密切相关,T2DM合并NAFLD者胰岛素抵抗明显,代谢综合征发生率更高。Objective To explore the relationship of non - alcohol fatty liver disease （NAFLD） to metabolic syndrome and insulin resistance （IR） in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 1 105 T2DM patients admitted to this hospital from January 2010 to December 2011 were divided, according to whether combined with NAFLD, into groups A （T2DM without NAFLD, n =472）, B （T2DM with NAFLD, n =633）. The clinical data were analyzed retrospectively. Re- sults Waist circumference, hip circumference, body mass index （BMI）, diastolic blood pressure, uric acid, total cholester- ol, triglycerides （TG）, low - density lipoprotein （ LDL - C）, alanine transarninase （ ALT）, glutamic oxaloacetic transami- nase （AST） , glutamyl endopeptidase, fasting C - peptide, and postprandial C - peptide were significantly higher in group B than in group A （ P 〈 0.05 ） ; Age, blood urea nitrogen, creatinine＇ and high - density lipoprotein significantly lower （ P 〈 0.05 ） ; Duration of diabetes significantly shorter （ P 〈 0. 05 ） ; The incidence of metabolic syndrome and hyperlipidemia signifi- cantly higher （P 〈 0. 05）. Logistic regression analysis showed that BMI, TG, LDL - C, ALT were independent risk factors of NAFLD, HDL- C was a protection factor. Conclusions NAFLD is closely associated with obesity, hyperlipidemia and IR. Patients with T2DM combined with NAFLD have high IR level with a higher incidence of metabolic syndrome.

关 键 词：糖尿病 2型 脂肪肝 非酒精性 代谢综合征 胰岛素抵抗 

分 类 号：R575.5[医药卫生—消化系统]