2型糖尿病患者一级亲属的糖代谢状态及其对非酒精性脂肪肝的影响  

Glucometabolic state in first-degree relatives of patients with type 2 diabetes mellitus and its influence on with nonalcoholic fatty liver disease

作　　者：谢勇丽[1] 张雅薇[1] XIE Yongli;ZHANG Yawei(Department of Endocrinology,Pingxiang People′s Hospital,Pingxiang,Jiangxi 337055,China)

机构地区：[1]萍乡市人民医院内分泌科,江西萍乡337055

出　　处：《现代医药卫生》2021年第24期4184-4187,4191,共5页Journal of Modern Medicine & Health

基　　金：江西省卫生计生委科技计划课题(20197277)。

摘　　要：目的分析2型糖尿病(T2DM)患者一级亲属的糖代谢状态及其对非酒精性脂肪性肝病(NAFLD)的影响。方法纳入2019年1月至2020年6月该院收治的T2DM患者300例,筛查一级亲属324例,按照筛查结果分为糖尿病(DM)组、糖调节受损(IGR)组、糖耐量正常(NGT)组。观察T2DM患者一级亲属中糖代谢异常发生率,比较3组的NAFLD发生率,检测3组的腰围(WC)、体重指数(BMI)、血糖指标[空腹血糖(FBG)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)]、胰岛功能指标[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)]、血脂指标[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]。采用logistic多元逐步回归分析各项指标对NAFLD的影响。结果T2DM患者一级亲属中糖代谢异常发生率为59.26%(192/324)。DM组、IGR组及NGT组一级亲属中NAFLD的发生率分别为60.00%(60/100)、41.30%(38/92)、25.76%(34/132),组间比较差异有统计学意义(P<0.05)。DM组的DM家族史比例、WC、BMI、FBG、2hPG、HbA1c、HOMA-IR、TG、TC、LDL-C水平均明显高于IGR组与NGT组,IGR组明显高于NGT组,DM组的FINS、HOMA-β、HDL-C水平均明显低于IGR组与NGT组,IGR组明显低于NGT组,差异均有统计学意义(P<0.05)。Logistic多元逐步回归分析显示,DM家族史、WC、BMI、FBG、HOMA-IR、TG是T2DM患者一级亲属发生NAFLD的主要影响因素(P<0.05)。结论T2DM患者一级亲属中糖代谢异常发生率较高,糖代谢异常一级亲属中NAFLD的发生率更高,DM家族史、WC、BMI、FBG、HOMA-IR、TG是影响T2DM患者一级亲属发生NAFLD的主要因素。Objective To analyse the glucometabolic state in first-degree relatives of patients with type 2 diabetes mellitus(T2DM)and its influence on with nonalcoholic fatty liver disease(NAFLD).Methods A total of 300 cases T2DM patients were included in our hospital from January 2019 to June 2020,and 324 cases first-degree relatives were screened.According to the screening results,the first-degree relatives were divided into diabetes mellitus(DM)group,impaired glucose regulation(IGR)group,normal glucose tolerance(NGT)group.The incidence rate of abnormal glucose metabolism in first-degree relatives were observed.The incidence rate of NAFLD was compared among 3 groups.The waist circumference(WC),body mass index(BMI),and blood glucose indexes[fasting blood glucose(FBG),2-hour post-meal blood glucose(2hPG),glycosylated hemoglobin(HbA1c)],islet function indexes[fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),index ofβ-cell function in HOMA(HOMA-β)],serum lipid indexes[triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)]were compared among 3 groups.The logistic stepwise regression was used to analyze the impact of various indicators on NAFLD.Results The incidence rate of abnormal glucose metabolism in first-degree relatives were 59.26%(192/324).The incidence rate of NAFLD in first-degree relatives of DM group,IGR group and NGT group were 60.00%(60/100),41.30%(38/92)and 25.76%(34/132),respectively,with statistical difference among the groups(P<0.05).The proportion of family history of DM,WC,BMI,FBG,2hPG,HbA1c,HOMA-IR,TG,TC and LDL-C level in DM group were significantly higher than those in IGR group and NGT group,IGR group were significantly higher than those NGT group,the differences were statistically significant(P<0.05).The FINS,HOMA-β,HDL-C level in DM group were significantly lower than those in IGR group and NGT group,IGR group were significantly lower than those NGT group,the differences were statistically signif

关 键 词：2型糖尿病 一级亲属 腰围 胰岛功能 非酒精性脂肪肝 影响因素 

分 类 号：R575[医药卫生—消化系统]