非酒精性脂肪肝合并2型糖尿病患者的肝脏脂肪含量与各代谢指标的相关性  

Correlation between Liver Fat Content and Metabolic Indexes in Patients with Non-alcoholic Fatty Liver Complicated with Type 2 Diabetes

作　　者：王思超 孙卫霞 成艺坪 侯琳 王蕾 赵萌[1] 马世瞻[1] 陈青[1] 李秋[1] 景斐[1] 邵珊珊[1] 管庆波[1] 周新丽[1] WANG Si-chao;SUN Wei-xia;CHENG Yi-ping(Department of Endocrinology,Department of Ultrasonic Diagnosis and Treatment,Shandong Provincial Hospital affiliated to Shandong University,Jinan,Shandong 250021,China)

机构地区：[1]山东大学附属省立医院内分泌科,山东济南250021 [2]山东大学附属省立医院超声诊疗科,山东济南250021

出　　处：《医学临床研究》2020年第2期189-192,共4页Journal of Clinical Research

基　　金：山东省重点研发计划(2017GSF18129);国家重点研发计划(2017YFC1309805)。

摘　　要：【目的】探讨超声定量检测2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者肝脏脂肪含量(LFC),并分析其与各代谢指标的相关性。【方法】选取T2DM合并NAFLD患者105例(观察组),另选无脂肪肝的单纯T2DM患者43例(对照组)。采用计算机辅助超声定量LFC,全自动生化分析仪检测各代谢指标血尿酸(SUA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿素氮(BUN)、游离脂肪酸(FFA)、糖化血红蛋白(HbA1C)、空腹血糖(FPG)、空腹胰岛素(FINS)、尿微量白蛋白(ALB)、尿肌酐(CREA),计算胰岛素抵抗指数(HOMA-IR=FPGF×FINS/22.5)。比较两组各代谢指标的差异并分析LFC与各指标的相关性。【结果】观察组ALT、TG、LDL-C、FPG、CREA、HOMA-IR水平、LFC均高于对照组,HDL-C水平低于对照组,其差异有统计学意义(P<0.05)。相关性分析显示:观察组中LFC与ALT、TG呈正相关;对照组中LFC与ALT、AST、TG呈正相关(P<0.05)。【结论】NAFLD作为T2DM的常见并发症,应用超声定量测定LFC,操作简单、成本低廉、无创便捷,可反映肝功血脂等相关指标变化,可作为入院常规筛检手段,为早期发现肝脏脂肪样变提供依据。【Objective】To evaluate the application of quantitative measurement of liver fat content(LFC)in patients with nonalcoholic fatty liver disease(NAFLD)complicated with type 2 diabetes mellitus(T2DM)by ultrasound,and to explore the correlation between quantitative results and metabolic indexes.【Methods】A total of 105 patients with NAFLD complicated with T2DM were selected as the observation group,and 43 T2DM patients without fatty liver disease were enrolled as the control group.The FIX was estimated by computer assisted ultrasound.Fully automatic biochemical analyzer detected various metabolic indexes such as serum uric acid(SUA),glutamic acid transaminase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholevSterol(HDL-C),Lowdensity lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),free fatty acids(FFA),glycated hemoglobin(HbA1C),fasting blood glucose(FPG),fasting insulin(FINS),urine microalbumin(ALB)and Urine creatinine(CREA).Insulin resistance index was calculated(HOMA-IR=FPGF×FINS/22.5).The differences in metabolic indexes between the two groups were compared and the correlation between LFC and each index was analyzed.【Results】The levels of ALT,TG,LDL-C,FPG,CREA,HOMA-IR,and LFC in the observation group were higher than those in the control group,while the level of HDL-C was lower than that in the control group;the differences were statistically significant(P<0.05).Correlation analysis showed that LFC was positively correlated with ALT and TG in the observation group;and LFC was positively correlated with ALT,AST,and TG in the control group(P<0.05).【Conclusion】As a common complication of T2DM.NAFLD is used to quantitatively determine LFC by ultrasound.It is simple,low-cost,non-invasive and convenient,and can reflect changes in related indexes such as liver function and lipids.It can be used as a routine screening method for admission and provide a basis for early detection of liver fatty changes.

关 键 词：糖尿病 2型/并发症 脂肪肝/并发症 

分 类 号：R587.1[医药卫生—内分泌]