中老年超重/肥胖人群代谢功能障碍相关脂肪性肝病与2型糖尿病的相关性研究  

A study on the relationship between metabolic dysfunction-associated fatty liver disease and type 2 diabetes mellitus in overweight/obese middle-aged and elderly population

作　　者：张雪冰 王连洁[1] 李潇然 王世东[1] Zhang Xuebing;Wang Lianjie;Li Xiaoran;Wang Shidong(Department of Endocrinology,Dongzhimen Hospital Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院内分泌科,北京100700

出　　处：《中国医学前沿杂志(电子版)》2025年第1期35-41,共7页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨中老年超重/肥胖人群代谢功能障碍相关脂肪性肝病(metabolic dysfunction-associated fatty liver disease,MAFLD)与2型糖尿病(type 2 diabetes mellitus,T2DM)的相关性。方法2011年11月至2012年8月,在北京市石景山区老山、金顶、苹果园3个社区进行以社区人群为基础的横断面调查,共调查≥40岁超重/肥胖居民13084例(男性4899例,女性8185例)。采用标准调查问卷,收集受试者的基本信息、生活方式、既往病史,根据已建立的标准方法对所有受试者进行体格检查。对于无糖尿病病史的受试对象行75 g口服葡萄糖耐量试验,对于既往有糖尿病病史者行标准馒头餐试验。测定空腹血糖(fasting plasma glucose,FPG)、总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、糖化血红蛋白(glycated hemoglobin A1c,HbA1c)和糖负荷后2 h血糖(2-hour plasma glucose,PG2h)。采用logistic回归分析MAFLD与T2DM的相关性。结果中老年超重/肥胖人群中,MAFLD的患病率为19.6%,MAFLD患者T2DM的患病率为35.9%;在消除年龄、糖尿病家族史、吸烟、饮酒、腹型肥胖、高血压、血脂异常等混杂因素后,MAFLD患者发生T2DM的风险是非MAFLD患者的1.566倍。T2DM个体发生MAFLD的风险是糖代谢正常个体的1.639倍。MAFLD组TC、TG、LDL-C、FPG、PG2h、HbA1c水平显著高于非MAFLD组;而HDL-C水平低于非MAFLD组。结论MAFLD是T2DM独立的危险因素,反之,T2DM亦增加了MAFLD的发生风险。Objective To explore the relationship between metabolic associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)in overweight/obese middle-aged and elderly population.Methods The study was a cross-sectional survey which was conducted in Laoshan,Jinding and Pingguoyuan communities in Shijingshan district,Beijing,China from November 2011 to August 2012.A total of 13084 overweight/obese residents(men,4899;women,8185)aged≥40 years were recruited in the study.Data on demographic information,lifestyle,and previous history of diabetes mellitus,hypertension,dyslipidemia were collected by standard questionnaires.All subjects were examined by trained physicians according to established standard methods.The subjects without history of diabetes were given a standard 75 g glucose solution,and the standard steamed bun meal test was performed in subjects with diabetes history.Fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),glycated hemoglobin A1c(HbA1c)and 2-hour plasma glucose(PG2h)were measured.The association between MAFLD and T2DM was evaluated by multivariate logistic regression.Results The overall prevalence of MAFLD was 19.6%in the overweight/obese middle-aged and elderly population.The prevalence of T2DM in the subjects with MAFLD was 35.9%.After adjustment for confounders including age,diabetic family history,smoking,alcohol intake,abdominal obesity hypertension,and dyslipidemia,multivariable logistic regression analysis shown that the odds ratio(OR)was 1.566(95%CI:1.403-1.748)for T2DM in the subjects with MAFLD,compared with those without MAFLD.The multiple logistic regression analysis demonstrated that the OR was 1.639(95%CI:1.472-1.824)for MAFLD in the participants with T2DM,compared with those with normal glucose tolerance(NGT).The average values of TC,TG,LDLC,FPG,PG2h,HbA1c were significantly higher in the subjects with MAFLD than those without MAFLD.On the contrary,serum HDL-C level was sign

关 键 词：代谢功能障碍相关脂肪性肝病 非酒精性脂肪性肝病 2型糖尿病 胰岛素抵抗 超重/肥胖 

分 类 号：R575.5[医药卫生—消化系统] R587.2[医药卫生—内科学]