2型糖尿病伴非酒精性脂肪肝与血尿酸水平和胰岛素抵抗的关系研究  

Correlation study of serum uric acid and insulin resistance in type 2 diabetes patients with non - alcoholic fatty Hver disease

作　　者：王百灵 刘静[2] 张琦[2] 安思芹[2] 李杨 

机构地区：[1]甘肃中医药大学临床医学院,甘肃省兰州730000 [2]甘肃省人民医院内分泌科,甘肃省兰州730000

出　　处：《中国基层医药》2018年第3期273-276,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：国家自然科学基金项目（81560146,81660148,81360131）;甘肃省卫生行业科研计划项目（GSWSKY-2015-10）

摘　　要：目的 探讨2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）与血尿酸（SUA）水平及胰岛素抵抗（IR）的相关性及其临床意义.方法 T2DM合并NAFLD组（合并组,n=54）,单纯T2DM组（n=50）,健康对照组（n=37）,测定三组的一般资料、SUA及IR水平并进行比较,分析NAFLD与SUA和IR的相关性.结果 合并组SUA、胰岛素抵抗指数（HOMA-IR）均高于单纯DM组和对照组（SUA：F=9.77,P=0.00;IR：H=122.13,P=0.00）;NAFLD与SUA、甘油三酯（TG）、IR呈显著正相关（r=0.323,P=0.00;r=0.294,P=0.00;r=0.331,P=0.00）;经Logistic回归分析发现,IR、SUA、TG是T2DM合并NAFLD的危险因素,回归系数分别为0.852、0.012、0.707.结论 SUA升高是T2DM合并NAFLD的独立危险因素,且与胰岛素抵抗呈正相关,控制SUA水平和改善胰岛素抵抗有助于延缓T2DM及NAFLD.Objective To investigate the correlation and clinical significance between serum uric acid （SUA） levels and insulin resistance in type 2 diabetes（T2DM） with non-alcoholic fatty liver disease （NAFLD）. Methods There were 54 T2DM patients with NAFLD in combined group ,50 cases in simple T2DM group and 37 cases in healthy group.The clinical parameters,SUA and insulin resistance （IR） levels were determined and compared among the three groups.The correlations among NAFLD,SUA levels and IR were analyzed.Results The SUA levels and IR index （ HOMA-IR） of the combined group were higher than those of the other two groups （ SUA：F=9.77,P=0.00;IR：H=122.13,P=0.00）.The studies showed that NAFLD was positively correlated with SUA , TG,HOMA-IR（r =0.323,P =0.00;r =0.294,P =0.00;r =0.331,P=0.00）.Logistic regression analysis revealed that IR,SUA and TG were the risk factors for T2DM with NAFLD（B=0.852,0.012,0.707）.Conclusion The increase of SUA is independent risk factor for T 2DM with NAFLD,so to control SUA and improve insulin sensitivity can help to prevent the development of T 2DM with NAFLD.

关 键 词：糖尿病 2型 脂肪肝 尿酸 胰岛素抗药性 

分 类 号：R575.5[医药卫生—消化系统] R587.1[医药卫生—内科学]