2型糖尿病周围神经病变合并脂肪肝患病率及危险因素分析  

Study on prevalance and risk factors of nonalcoholic fatty liver diseases of patients with type 2 diabetic peripheral neuropathy

作　　者：司阳 朱琳[1] 商洪涛[1] SI Yang;ZHU Lin;SHANG Hongtao(Jiangsu province hospital of Chinese medicine,Nanjing,Jiangsu 210029,China)

机构地区：[1]江苏省中医院,江苏南京210029

出　　处：《现代医药卫生》2021年第20期3470-3473,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨2型糖尿病周围神经病变合并脂肪肝患病率及其危险因素。方法选取2019年1月至2020年5月该院内分泌科收治的住院糖尿病周围神经病变患者(符合1999年世界卫生组织诊断标准)409例,根据B超检查结果分为非酒精性脂肪肝(NAFLD)组(173例)和无NAFLD组(236例),收集2组患者血生化、尿检等资料。结果409例2型糖尿病周围神经病变患者NAFLD患病率为42.3%(173/409),50岁前男性NAFLD发病率明显高于女性,50岁以后则明显低于女性,60~<70岁女性患病率明显高于男性,差异均有统计学意义(P<0.05)。NAFLD组患者超重/肥胖、血脂紊乱、代谢综合征患病率均明显高于无NAFLD组,差异均有统计学意义(P<0.05);随代谢异常组分的增加,NAFLD患病风险增加,其中4种代谢异常者较单纯糖尿病者NAFLD患病风险幅度增加5.9倍,差异有统计学意义(P<0.05)。NAFLD组患者体重指数(BMI)、收缩压、谷草转氨酶、谷丙转氨酶、γ-谷氨酰转肽酶、空腹胰岛素、胰岛素抵抗指数、三酰甘油(TG)、总胆固醇、空腹C肽、尿微量清蛋白/肌酐均明显高于无NAFLD组,糖尿病病程、高密度脂蛋白胆固醇明显低于无NAFLD组,差异均有统计学意义(P<0.05)。BMI、TG与NAFLD呈独立正相关,糖尿病病程与后者呈独立负相关。结论住院2型糖尿病周围神经病变患者中超过2/5的患者存在NAFLD,脂肪肝与代谢综合征关系密切,BMI、TG、糖尿病病程是脂肪肝的独立危险因素,控制代谢异常对该类患者意义重大。Objective To study the prevalence and risk factors of non alcoh-olic fatty liver diseases(NAFLD)of patients with type 2 diabetic peripheral ne-uropathy.Methods A total of 409 inpatients with diabetic peripheral neuropathy(in line with the 1999 WORLD Health Organization diagnostic criteria)admitted to the Department of Endocrinology of our hospital from January 2019 to May 2020 were divided into non-alcoholic fatty liver disease(NAFLD)group(173 cases)and non-NAFLD group(236 cases)according to the results of B-ultrasonography.The data of blood biochemistry and urine test were collected.Results The prevalence of NAFLD in 409 patients with type 2 diabetic peripheral neuropathy was 42.3%(173/409).The incidence of NAFLD in males was significantly higher than that in females before the age of 50,and significantly lower than that in females after the age of 50.The prevalence rate in females aged 60-<70 years was significantly higher than that in males,and the differences were statistically significant(P<0.05).The risk of NAFLD increased with the increase of abnormal metabolic components,and the risk of NAFLD increased 5.9 times in patients with 4 metabolic abnormalities compared with those with diabetes alone,with statistical significance(P<0.05).The body mess index(BMI),diastolic blood pressure(SBP),aspartate aminotransferase(AST),alanine-aminotrans-ferase(ALT),glutamine-transaminase(r-GT),fastig insulin(F-INS),insulin resistance index(HOMA-IR),triglyceride(TG),total cholesterol(TC),fasting peptide Curine miroalbumin via creatinine were higher than those of control group(P<0.05).The course of diabetes mellitus,the leval of serum high density lipoprotein-cholesterol were lower than those of control group(P<0.05).BMI and TG were independently positively correlated with NAFLD,and the course of diabetes mellitus was independently negatively correlated with NAFLD.Conclusion More than 2/5 of in-patients with type 2 diabetic peripheral neuropa-thy had NAFLD.NAFLD was closely associated with metabolic syndrome.The course of dia

关 键 词：糖尿病 2型 糖尿病神经病变 周围神经系统疾病 脂肪肝 患病率 危险因素 

分 类 号：R587.2[医药卫生—内分泌]