Ⅱ型糖尿病合并非酒精性脂肪肝流行状况与危险因素  

Study on prevalence and risk factors of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease

作　　者：刘林杰 李慧琼[1,2] 徐焱成 LIU Linjie;LI Huiqiong;XYU Yancheng(Department of Endocrinology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Endocrinology,The Third Clinical Medical College of Three Gorges University/Gezhouba Central Hospital,Yichang,Hubei 443001,China)

机构地区：[1]武汉大学中南医院内分泌科,武汉430071 [2]三峡大学第三临床医学院/葛洲坝中心医院内分泌科

出　　处：《公共卫生与预防医学》2019年第3期40-43,共4页Journal of Public Health and Preventive Medicine

基　　金：国家自然基金项目(30871188)

摘　　要：目的探讨Ⅱ型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)流行状况和危险因素分析。方法选取2011年12月至2017年5月在武汉大学中南医院内分泌科住院的Ⅱ型糖尿病患者1259例,一项单中心横断面研究。根据是否NAFLD分为单纯T2DM组和T2DM并NAFLD组,分析NAFLD流行状况,二项Logistic回归分析T2DM合并NAFLD的危险因素。结果共纳入1259例,T2DM并NAFLD为774例,患病率为61.48%;亚组分析,糖尿病病程<1年,1≤且<5年,5≤且<10年,≥10年NAFLD患病率分别为67.21%、64.40%、63.60%、54.52%;青年组、中年组、老年组NAFLD患病率分别为76.5%、64.5%、56.7%;正常体重、超重、肥胖NAFLD患病率分别为42.44%、68.74%、83.27%;有血脂异常、无血脂异常NAFLD患病率分别为67.01%、42.66%。Logistic回归分析显示,校正混杂因素后,BMI、ALT、TG、2h血糖是T2DM并NAFLD的独立危险因素,糖尿病病程是其保护性因素(P<0.05)。结论T2DM并NAFLD患病率较高,BMI、ALT、TG、2h血糖是T2DM并NAFLD的独立危险因素,糖尿病病程是其保护性因素。Objective To investigate the prevalence and risk factors of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM). Methods 1 259 T2DM patients hospitalized in Zhongnan Hospital of Wuhan University from December 2011 to May 2017 were included in this study. According to the status of NAFLD,the patients were divided into simple diabetes group and T2DM+NAFLD group. The prevalence of NAFLD was analyzed,and the risk factors of T2DM complicated with NAFLD were analyzed by binomial Logistic regression analysis. Results Among 1 259 T2DM patients,774 patients had NAFLD,and the prevalence of NAFLD was 61.5%. Analysis of subgroups showed that the prevalence rates of NAFLD were 67.2%,64.4%,63.6%,and 54.5%,in patients with diabetes duration<1 year,1 to 5 years,5 to 10 years,and ≥10 years,respectively. The prevalence rates of NAFLD were 76.5%,64.5%,and 56.7%,respectively,in the youth group,middle aged group and the elderly group. The prevalence rates of NAFLD were 42.4%,68.7%,and 83.3% in normal weight,overweight,and obesity,respectively. The prevalence rates of NAFLD with or without dyslipidemia were 67.2% and 43.1%,respectively. Logistic regression analysis showed that BMI,ALT,TG,and 2h blood glucose were independent risk factors for T2DM and NAFLD,and the duration of diabetes was a protective factor ( P <0.05). Conclusion The prevalence of NAFLD in T2DM was high. BMI,ALT,TG,and 2h blood glucose were independent risk factors for T2DM and NAFLD,and the duration of diabetes was a protective factor.

关 键 词：Ⅱ型糖尿病 非酒精性脂肪肝 患病率 危险因素 

分 类 号：R151.1[医药卫生—营养与食品卫生学]