人体测量指标对2型糖尿病患者非酒精性脂肪肝进展的预测作用  

Predictive effect of anthropometric indicators on the progression of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

作　　者：万静[1] 杜炜[1] 卢叶[1] 宋静[1] 赵芳雅 陈海冰 WAN Jing;DU Wei;LU Ye;SONG Jing;ZHAO Fang-ya;CHEN Hai-bing(Department of Endocrinology and Metabolism, Shanghai Eighth People’s Hospital, Shanghai 200235, China;Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Department of Endocrinology and Metabolism, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China)

机构地区：[1]上海市第八人民医院内分泌代谢科,上海200235 [2]上海市糖尿病研究所上海市糖尿病重点实验室上海市糖尿病临床医学中心上海交通大学附属第六人民医院内分泌代谢科,上海200233

出　　处：《中国临床医学》2018年第6期919-923,共5页Chinese Journal of Clinical Medicine

基　　金：上海市徐汇区高峰学科(15304);上海市徐汇区医学科技项目(SHXH201649);上海市徐汇区卫计委课题(SHXH201329)~~

摘　　要：目的:探讨人体测量学指标,包括体质指数、腰围、腰围/身高、腰臀比等,对住院2型糖尿病患者非酒精性脂肪性肝病(NAFLD)进展情况的预测作用。方法:连续纳入资料完整的住院2型糖尿病者535例,采集人口学资料、人体测量学指标和实验室化验数据。根据NAFLD进展情况,将其分为进展组和非进展组,分析两组临床特征。采用二分类logistic回归模型分析各指标与NAFLD进展的相关性;使用受试者工作曲线进行检验效力分析。结果:535例患者中,进展组患146例、非进展组389例。与非进展组相比,进展组年龄较小,体质指数、腰围、腰围/身高、腰臀比较大,三酰甘油、尿酸、丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平较高(P<0.05)。二分类logistic回归模型显示,体质指数、腰围、腰围/身高、腰臀比为2型糖尿病患者发生NAFLD的独立危险因素(P=0.000)。ROC曲线分析结果显示,体质指数、腰围、腰围/身高、腰臀比预测NAFLD进展的曲线下面积(AUC)分别为0.675、0.677、0.664、0.642,截断值分别为24.23kg/m2、93.5cm、0.57、0.89(P=0.000)。结论:体质指数、腰围、腰围/身高和腰臀比均可预测2型糖尿病患者NAFLD的发生。Objective:To explore the role of anthropometric indicators(body mass index,waist circumference,waist circumference height ratio,waist-to-hip ratio,etc.)in predicting the progression of non-alcoholic fatty liver disease(NAFLD)in patients with type2diabetes mellitus.Methods:A total of535consecutive patients with type2diabetes mellitus were enrolled,and demographic data,anthropometric indicators,and laboratory test data were collected.According to whether NAFLD presented or not,the patients were divided into the progression group and the non-progression group,and the clinical characteristics of the two groups were analyzed.The regression analysis was performed using the binary logistic regression model,and the test efficacy analysis was performed using the receiver operating characteristic curve(ROC).Results:Compared with the non-progression group(n=389),patients in fatty liver progression group(n=146)were younger,and the body mass index,waist circumference,waist circumference height ratio,waist-to-hip ratio,triglyceride,uric acid,alanine,and aspartate aminotransferase were significantly higher(P<0.05).The multiple regression analysis results showed that body mass index,waist circumference,waist circumference height ratio,waist-to-hip ratio were independent risk factors for the development of NAFLD in patients with type2diabetes respectively(P=0.000).ROC analysis showed that AUCs for body mass index,waist circumference,waist circumference height ratio,and waist-to-hip ratio were0.675,0.677,0.664,and0.642,respectively,and the best cut-off points for predicting NAFLD were24.23kg/m^2,93.5cm,0.57,and0.89,respectively(P=0.000).Conclusions:Body mass index,waist circumference,waist circumference height ratio,and waist-to-hip ratio all can predict the progression of NAFLD in patients with type2diabetes.

关 键 词：人体测量指标 2型糖尿病 非酒精性脂肪性肝病 

分 类 号：R587.1[医药卫生—内分泌]