中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
9期
33-36
,共4页
2型糖尿病%脂肪肝%危险因素
2型糖尿病%脂肪肝%危險因素
2형당뇨병%지방간%위험인소
Type 2 diabetes mellitus%Fatty liver%Risk factors
目的 探讨汉族2型糖尿病(T2DM)病人发生非酒精性脂肪肝(NAFLD)的危险因素及其预测价值.方法 收集我院2009年1月至12月门诊汉族T2DM病人,进行腹部B超检查以判断有无NAFLD,同时检测体质量、腰围、血糖、血脂、胰岛素,计算体质量指数(BMI)和胰岛素抵抗指数,并进行糖尿病并发症的全面检查.结果 共收集360例T2DM病人,其中52.2%(188/360)患有NAFLD.单因素对比发现,NAFLD组的BMI、腰围、胰岛素、胰岛素抵抗、甘油三酯、低密度脂蛋白水平较非NAFLD组显著升高(P<0.05),但多因素Logistic回归提示仅腰围和甘油三酯为独立的NAFLD危险因素(P<0.05).NAFLD与血糖控制指标及各种糖尿病并发症无关(P>0.05).受试者工作特征曲线显示腰围和甘油三酯对NAFLD的发生均有预测价值,但腰围的预测价值更大.以84 cm作为腰围的预测截断值,预测敏感性和特异性分别为80%和72%.结论 T2DM病人NAFLD患病率高,腰围和甘油三酯为其独立的危险因素.腰围为NAFLD发生较好的预测指标,以84 cm作为预测临界值时,具有较好的预测敏感及特异性.
目的 探討漢族2型糖尿病(T2DM)病人髮生非酒精性脂肪肝(NAFLD)的危險因素及其預測價值.方法 收集我院2009年1月至12月門診漢族T2DM病人,進行腹部B超檢查以判斷有無NAFLD,同時檢測體質量、腰圍、血糖、血脂、胰島素,計算體質量指數(BMI)和胰島素牴抗指數,併進行糖尿病併髮癥的全麵檢查.結果 共收集360例T2DM病人,其中52.2%(188/360)患有NAFLD.單因素對比髮現,NAFLD組的BMI、腰圍、胰島素、胰島素牴抗、甘油三酯、低密度脂蛋白水平較非NAFLD組顯著升高(P<0.05),但多因素Logistic迴歸提示僅腰圍和甘油三酯為獨立的NAFLD危險因素(P<0.05).NAFLD與血糖控製指標及各種糖尿病併髮癥無關(P>0.05).受試者工作特徵麯線顯示腰圍和甘油三酯對NAFLD的髮生均有預測價值,但腰圍的預測價值更大.以84 cm作為腰圍的預測截斷值,預測敏感性和特異性分彆為80%和72%.結論 T2DM病人NAFLD患病率高,腰圍和甘油三酯為其獨立的危險因素.腰圍為NAFLD髮生較好的預測指標,以84 cm作為預測臨界值時,具有較好的預測敏感及特異性.
목적 탐토한족2형당뇨병(T2DM)병인발생비주정성지방간(NAFLD)적위험인소급기예측개치.방법 수집아원2009년1월지12월문진한족T2DM병인,진행복부B초검사이판단유무NAFLD,동시검측체질량、요위、혈당、혈지、이도소,계산체질량지수(BMI)화이도소저항지수,병진행당뇨병병발증적전면검사.결과 공수집360례T2DM병인,기중52.2%(188/360)환유NAFLD.단인소대비발현,NAFLD조적BMI、요위、이도소、이도소저항、감유삼지、저밀도지단백수평교비NAFLD조현저승고(P<0.05),단다인소Logistic회귀제시부요위화감유삼지위독립적NAFLD위험인소(P<0.05).NAFLD여혈당공제지표급각충당뇨병병발증무관(P>0.05).수시자공작특정곡선현시요위화감유삼지대NAFLD적발생균유예측개치,단요위적예측개치경대.이84 cm작위요위적예측절단치,예측민감성화특이성분별위80%화72%.결론 T2DM병인NAFLD환병솔고,요위화감유삼지위기독립적위험인소.요위위NAFLD발생교호적예측지표,이84 cm작위예측림계치시,구유교호적예측민감급특이성.
Objective To explore the risk factors of non-alcoholic fatty liver(NAFLD) in Han type 2 diabetes mellitus(T2DM) population and to evaluate the prediction value of the risk factors for NAFLD. Methods Han outpatient T2DM patients of our hospital were recruited from Jan. 2009 to Dec. 2009. Abdominal ultrasonography was performed for each patient to diagnose NAFLD. Body weight, waist circumference, plasma insulin, plasma glucose and plasma lipid were measured. Body mass index(BMI) and insulin resistance index were calculated. Thorough physical and instrumental examinations were performed to evaluate the diabetic complications. Results Three hundred and sixty T2DM patients were recruited, one hundred and eighty-eight patients among them were diagnosed as NAFLD(52.2%). One-factor analysis revealed that BMI, waist circumference, plasma insulin level, insulin resistance index, plasma triglyceride level and plasma low density lipoprotein level were significantly higher in NAFLD than that in the non-NAFLD T2DM patients(P<0.05). Multifactorial Logistic regression showed that only waist circumference and plasma triglyceride level were independent risk factors for NAFLD(P<0.05). No association was found between NAFLD and blood glucose as well as diabetic complications(P>0.05). The receiver operating characteristic curves demonstrated that waist circumference was better than plasma triglyceride level in predicting the presence of NAFLD. The prediction sensitivity and specificity were 80% and 72%, respectively with 84 cm being the best cutoff value of waist circumference. Conclusions There is a high prevalence of NAFLD in T2DM patients with waist circumference and plasma triglyceride level being independent risk factors. Waist circumference does better in predicting the presence of NAFLD with the best cutoff value of 84 cm.
