2型糖尿病合并非酒精性脂肪性肝病患者发生房颤的危险因素  

Risk factors for atrial fibrillation in patients with non-alcoholic fatty liver disease combined with type 2 diabetes

作　　者：雷微[1] 王艳丽[1] 

机构地区：[1]重庆市第三人民医院消化内科,重庆400014

出　　处：《重庆医科大学学报》2017年第7期879-882,共4页Journal of Chongqing Medical University

摘　　要：目的:探讨2型糖尿病合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者发生心房纤颤(atrial fibrillation,AF)的危险因素。方法:选取2010年9月至2014年6月我院2型糖尿病合并NAFLD患者共208例,收集一般临床资料,常规检查心电图,腹部彩超,将入组患者分为房颤组和非房颤组,然后采用多因素logistic回归模型筛选主要危险因素。结果:房颤组患者的体质量指数、糖化血红蛋白、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇、甘油三酯、谷草转氨酶、谷氨酰转肽酶水平明显高于非房颤组(P<0.05);同时,房颤组患者中有糖尿病家族史、脂肪肝家族史、吸烟比例亦明显高于非房颤组(P<0.01),且年龄明显高于非房颤组患者(P<0.01)。单因素logistic回归分析表明:2型糖尿病合并NAFLD患者发生房颤与性别、年龄、体质指数、糖尿病家族史、脂肪肝家族史、高血压、糖化血红蛋白、总胆固醇、低密度脂蛋白显著相关(P<0.05);多因素logistic回归分析表明:仅年龄和TC是2型糖尿病合并NAFLD患者发生房颤的危险因素(OR=2.769,95%CI=1.329~5.769,P=0.007;OR=1.435,95%CI=1.027~2.014,P=0.005)。结论:年龄和TC是2型糖尿病合并NAFLD患者发生房颤的危险因素,对于2型糖尿病合并NAFLD的患者更应注意对胆固醇的控制。Objective：To study risk factors for atrial fibrillation（AF）in patients with non-alcoholic fatty liver disease （NAFLD） com- bined with type 2 diabetes. Methods：Totally 208 patients with NAFLD combined with type 2 diabetes were enrolled and the general clinical data and results of conventional electrocardiogram examination, and abdominal uhrasonography were collected. Patients were further divided into AF group and non-AF group,then multiple factors logistic regression model was used to screen the main risk factors. Results：The levels of body mass index, haemoglobin A l c, total cholesterol （TC）, low density lipoprotein cholesterol, triglyceride, glutamic-oxaloacetic transaminase and glutamyl transpeptidase in AF group were higher than those in non-AF group（P〈O.05）. Mean- while, the proportions of family history of diabetes and fatty liver disease as well as smoking in AF group were higher than those in non-AF group（P〈O.01）. In addition, patients in AF group were older compared with non-AF group （P〈0.01）. Univariate logistic re- gression analysis showed that male gender, age, body mass index, family history of diabetes and fatty liver disease, hypertension, levels of haemoglobin Alc,TC and low density lipoprotein cholesterol were significantly related to higher incidence of AF in patients with both NAFLD and type 2 diabotes（P〈O.05）： The age and levels of TC were positive risk factors for AF in the patients with both NAFLD and type 2 diabetes according to the following multivariate logistic regression analysis（OR=2.769,95%CI=1.329 to 5.769 ,P=-0.O07 ;OR= 1.435,95%CI=1.027 to 2.014 ,P=0.005）. Conclusion：The age and TC levels are the risk factor for AF in the patients with NAFLD combined with tvoe 2 diabetes mellitus.

关 键 词：2型糖尿病 非酒精性脂肪性肝病 心房纤颤 

分 类 号：R589.9[医药卫生—内分泌]