2型糖尿病血糖波动与非酒精性脂肪性肝病肝纤维化评分的相关性研究  

Correlation between glycemic variability and nonalcoholic fatty liver disease fibrosis score in patients with type 2 diabetes mellitus

作　　者：范雪梅[1] 赵凌霞[1] 郗光霞[1] 杨坤[1] 李晓丽[1] Fan Xuemei;Zhao Lingxia;Xi Guangxia;Yang Kun;Li Xiaoli(Department of Endocrinology,Shanxi Dayi Hospital,Shanxi Academy of Medical Sciences,Taiyuan 030032,China)

机构地区：[1]山西医学科学院山西大医院内分泌科

出　　处：《中国药物与临床》2019年第11期1765-1767,共3页Chinese Remedies & Clinics

基　　金：山西省自然科学基金(2013011048-3)

摘　　要：目的探讨2型糖尿病(T2DM)血糖波动对非酒精性脂肪性肝病(NAFLD)肝纤维化的影响。方法所有研究对象为2016-2018年于山西大医院内分泌科住院的无血缘关系的T2DM患者,除外酒精和其他明确肝损害因素所致的肝脏疾病,根据NAFLD肝纤维化评分(NAFLDFS)将受试的54例T2DM患者分为3组:T2DM+F0组为NAFLDFS<-1.455,T2DM+F1组为-1.455≤NAFLDFS≤0.676,T2DM+F2组为NAFLDFS>0.676。比较3组的体质量指数(BMI)、腰围(WC)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、平均血糖波动幅度(MAGE)、糖化血红蛋白(HbA1c)等指标,并进行Logistic回归分析。结果与T2DM+F0组比较,T2DM+F1和T2DM+F2组BMI、腰围、SBP、DBP、FPG、TC、TG、LDL-C、MAGE、HbA1c均升高,差异有统计学意义(P<0.05);HDL-C水平降低,但差异无统计学意义(P>0.05)。T2DM+F2组与T2DM+F1组比较,BMI、腰围、SBP、DBP、LDL-C、MAGE水平明显升高,差异有统计学意义,但2组间HbA1c差异无统计学意义(P>0.05)。MAGE是NAFLDFS的独立危险因素[OR值(95%CI)=1.916(0.831,3.705)]。结论血糖波动MAGE与NAFLDFS独立相关。Objective To investigate the effect of glycemic variability on nonalcoholic fatty liver disease(NAFLD)fibrosis in type 2 diabetes mellitus(T2DM).Methods The T2DM unrelated patients admitted to the department of endocrinology in Shanxi Dayi Hospital between 2016 and 2018 were included as the subjects in the study.Excluding the liver diseases caused by alcohol and other definite liver damage factors,54 T2DM patients were divided into 3 groups according to the NAFLD fibrosis score(NAFLDFS):T2DM+F0 group(NAFLDFS<-1.455),T2DM+F1 group(-1.455≤NAFLDFS≤0.676)and T2DM+F2 group(NAFLDFS>0.676).The body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),mean amplitude of glycemic excursions(MAGE),and glycosylated hemoglobin(HbA1c)in the three groups were compared,and the Logistic regression analysis was performed.Results Compared with T2DM+F0 group,the levels of BMI,WC,SBP,DBP,FPG,TC,TG,LDL-C,MAGE and HbA1c increased in T2DM+F1 and T2DM+F2 groups,with statistically significant differences(P<0.05);whereas the HDL-C level decreased,with no statistically significant difference(P>0.05).Compared with T2DM+F1 group,the levels of BMI,WC,SBP,DBP,LDL-C and MAGE in the T2DM+F2 group significantly increased,with statistically significant differences.There was no statistically significant difference in the HbA1c level between the two groups(P>0.05).MAGE was an independent risk factor for NAFLDFS[OR(95%CI)=1.916(0.831,3.705)].Conclusion Glycemic variability is independently correlated with NAFLDFS.

关 键 词：糖尿病 2型 肝硬化 非酒精性脂肪性肝病 

分 类 号：R587.1[医药卫生—内分泌] R575[医药卫生—内科学]