葡萄糖管理指标与2型糖尿病患者发生非酒精性脂肪性肝病的相关性分析  

Relationship between glucose management indicator and risk of developing non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

作　　者：李旭 杜晓洋 闫晓玲 田德增[1] LI Xu;DU Xiaoyang;YAN Xiaoling;TIAN Dezeng(Department of Endocrinology,Anyang District Hospital,Anyang,Henan 455000,China)

机构地区：[1]河南省安阳地区医院内分泌科,河南安阳455000

出　　处：《淮海医药》2025年第1期32-36,共5页Journal of Huaihai Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210153)。

摘　　要：目的:探讨葡萄糖管理指标(GMI)与2型糖尿病(T2DM)患者发生非酒精性脂肪性肝病(NAFLD)的相关性。方法:选取2022年9月—2023年9月某院180例T2DM患者为研究对象,根据是否合并NAFLD分为单纯组(n=74)和合并组(n=106)。比较2组一般资料[性别、年龄、T2DM病程、BMI、收缩压(SBP)、舒张压(DBP)]、生化指标{空腹血糖(FBG)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IDBIL)、血尿素氮(BUN)、尿酸(UA)、血肌酐(SCR)、总胆固醇(TC)、甘油三酯(TG)、血红蛋白(Hb)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbAlc)、空腹C肽(FCP)、空腹胰岛素(FINS)、25羟维生素D[25(OH)D]}及连续性血糖监测相关指标[葡萄糖管理指标(GMI)、平均葡萄糖值(MG)、葡萄糖在目标范围内时间(TIR)、葡萄糖高于目标范围时间(TAR)、葡萄糖低于目标范围时间(TBR)、平均葡萄糖变异系数(CV)、平均葡萄糖标准差(SD)]水平。采用Pearson系数分析T2DM合并NAFLD患者GMI与各个指标的相关性,多因素Logistic回归方程分析T2DM发生NAFLD的影响因素。结果:2组性别、病程、年龄及DBP、Hb、FPG、25(OH)D、I-BIL、GGT、ALP、BUN、Scr、TC、LDL-C水平比较,差异无统计学意义(P>0.05);合并组BMI、SBP、HbA1c、FCP、FINS、T-BIL、D-BIL、ALT、AST、UA及TG水平高于单纯组,HDL-C水平低于单纯组,差异有统计学意义(P<0.05)。2组平均葡萄糖CV比较,差异无统计学意义(P>0.05);合并组GMI、MG、TAR、平均葡萄糖SD高于单纯组,TIR、TBR水平低于单纯组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,T2DM合并NAFLD患者GMI与HbA1c、MG、TAR、平均葡萄糖SD呈正相关(r=0.229、1.007、0.956、0.812,P<0.05),与TBR、TIR呈负相关(r=-0.292、-0.949,P<0.05)。多因素Logistic回归分析显示,低HDL-C水平为T2DM患�Objective:To explore the correlation between glucose management index(GMI)and nonalcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods:180 T2DM patients admitted to a hospital from September 2022 to September 2023 were selected as the study subjects.They were divided into a simple group(n=74)and a combined group(n=106)based on whether they had NAFLD.The two groups were compared in terms of general information[gender,age,T2DM course,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP)],and biochemical indicators[FBG,ALT,AST,GGT,ALP,TBIL,DBIL,IDBIL,BUN,UA,SCR,TC,TG,Hb,HDL-C,LDL-C,HbAlc,FCP,FINS,25(OH)D],and CGM related indicators(GMI,MG,TIR,TAR,TBR,CV,SD).Spearman analysis was used to investigate the correlation between GMI and various indicators in T2DM patients with NAFLD.Multivariate logistic regression equation was used to analyze the influencing factors of NAFLD in T2DM.Results:There was no significant difference in gender,disease duration,age,DBP,Hb,FPG,25(OH)D,I-BIL,GGT,ALP,BUN,Scr,TC,LDL-C levels between the two groups(P>0.05).The levels of BMI,SBP,HbA1c,FCP,FINS,T-BIL,D-BIL,ALT,AST,UA,and TG in the combined group were higher than those in the simple group,while the level of HDL-C was lower than that in the simple group,with the differences being statistically significant(P<0.05).There was no statistically significant difference in CV levels between the two groups(P>0.05).The GMI,MG,TAR,and SD levels in the combined group were higher than those in the simple group,while the TIR and TBR levels were lower than those in the simple group,with statistically significant differences(P<0.05).Spearman correlation analysis showed that in the106 patients with T2DM complicated with NAFLD,GMI was positively correlated with HbA1c,MG,TAR,and SD(r=0.229,1.007,0.956,0.812,P<0.05),and negatively correlated with TBR and TIR(r=-0.292,-0.949,P<0.05).Multivariate logistic regression analysis showed that low HDL-C was a protective factor for NAFLD in T2DM patients,w

关 键 词：糖尿病 2型 非酒精性脂肪肝病 葡萄糖管理指标 持续葡萄糖监测 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]