2型糖尿病患者非酒精性脂肪性肝病与白蛋白尿的关系  

Association of nonalcoholic fatty liver disease and albuminuria in patients with type 2 diabetes mellitus

作　　者：姚培培[1] 吕文山[2] 高燕燕[1] 孙瑞霞[1] 李莉[1] 王静[1] 孙丽萍[1] 郭娅棣[1] 

机构地区：[1]青岛大学附属医院东院区内分泌科,266100 [2]青岛大学附属医院内分泌科

出　　处：《中华内分泌代谢杂志》2014年第1期13-17,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金项目（81270939）

摘　　要：目的探讨2型糖尿病患者非酒精性脂肪性肝病（NAFLD）患病情况及其与白蛋白尿的关系。方法将1205例住院2型糖尿病患者根据B超结果分为NAFLD组和无NAFLD组：按晨尿白蛋8／肌酐比值分为无白蛋白尿（NA）组和白蛋白尿（Au）组。收集患者一般临床资料及实验室检查结果，运用x^2检验及二元logistic回归等统计学方法进行分析。结果（1）2型糖尿病患者NAFLD检出率为60．8％，logistic回归分析显示NAFLD与甘油-N、体重指数（BMI）、空腹血糖、腰围、舒张压、收缩压呈正相关（均P〈0．05）．与血肌酐、糖尿病病程、AU、高密度脂蛋白胆固醇（HDL—C）呈负相关（均P〈0．05）；（2）患者AU检出率为31．0％，logistic回归分析显示AU与总胆固醇、HbA1c、BMI、糖尿病病程、收缩压、血肌酐呈正相关（均P〈0．05），与NAFLD和HDL—C负相关（均P〈0．01）；（3）根据患者年龄、糖尿病病程分层研究显示NAFLD检出率随年龄和病程增加而降低（P〈0．05）；Au检出率随年龄和病程增加而升高（P〈0．05）。AU组NAFLD检出率显著低于NA组（53．4％对64．2％，P〈0．05），偏相关分析显示，校正年龄和病程后，AU和NAFLD无相关性（P〉0．05）。结论随年龄和糖尿病病程增加2型糖尿病住院患者NAFLD检出率有下降趋势，而AU检出率增加，NAFLD的发生与Au负相关，但校正年龄和病程后二者无相关性。Objective To investigate the prevalence and risk fatcors of nonalcoholic fatty liver disease （NAFLD） and its relationship with albuminuria in in-patients with type 2 diabetes mellitus （ T2DM ）. Methods A total of 1 205 in-patients with T2DM were enrolled in this study. The patients were divided into NAFLD group and non- NAFLD group by mean of liver ultrasonography, and into negative albuminuria group （ NA ） and albuminuria group （AU） according to albumin-to-creatinine ratio. The general information and laboratory data of patients were collected. Chi-square test and binary logistic regression analysis were conducted. Results （ 1 ） The prevalence of NAFLD in the patients with T2DM was 60. 8%. Binary logistic regression revealed that NAFLD was positively correlated with triglyceride, body mass index （BMI） , fasting plasma glucose, waist circumference, diastolic blood pressure, and systolic blood pressure （SBP） , and negatively correlated with serum creatinine, duration of diabetes, AU, and high density lipoprotein-eholesterol （ HDL-C, all P〈0.05 ）. （2） The prevalence of AU was 31.0% in these patients. Binary logistic regression revealed that AU was positively correlated with total cholesterol （ TC ） , HbA1c, BMI, duration of diabetes, SBP, and creatinine; and negatively correlated with NAFLD and HDL-C （all P 〈 0.05 ）. （3） As subjects were divided into three groups based on their age, the prevalence of NAFLD was decreased and that of AU was increased with aging and diabetes duration （ all P〈0.05 ）. The prevalence of NAFLD in patients with AU was significantly lower than that in patients without AU （ 53.4% vs 64.2%, P〈0.05 ）. Partial correlations analysis indicated no significant correlation between NAFLD and AU after being adjusted by age and duration of diabetes（P〉0.05）. Conclusions With aging and prolonged diabetes, the prevalence of NAFLD is decreased and that of AU is increased. NAFLD is negatively correlated with AU, but this correlation does

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 白蛋白尿 

分 类 号：R587.1[医药卫生—内分泌]