CAJ | 학술논문

目的探讨新诊断2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者的临床代谢特点,并分析影响NAFLD的危险因素.方法选择新诊断的2型糖尿病患者142例,根据是否合并NAFLD分为A组(T2DM不合并NAFLD)(79例)、B组(T2DM合并NAFLD)(63例),所有受试者均测量身高、体质量及血压,检测空腹血糖(FPG)、血脂、尿酸(UA)、糖化血红蛋白(HbA1c)、空腹血清胰岛素(FINS),计算体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR),比较两组间临床及生化指标的特点.结果 (1)A、B两组的年龄及血压比较差异无统计学意义(P均＞0.05).B组BMI(26.79±1.93)kg/m2、FINS(15.49 ±2.44) mU/L、HOMA-IR(6.74±1.32)、甘油三酯(TG) (2.94±0.65) mmol/L、低密度脂蛋白胆固醇(LDL-C)(3.46±0.73) mmol/L、UA(342.41 ±71.49) mmol/L均高于A组BMI(24.61±2.46) kg/m2、FINS(13.20±2.17) mU/L、HOMA-IR(5.65±1.10)、TG(1.74±0.46) mmol/L、LDL-C(2.78±0.86) mmol/L、UA(312.98 ±66.24) mmol/L,高密度酯蛋白胆固醇(HDL-C)(0.99±0.17)mmol/L低于A组(1.21±0.29) mm0l/L,两组比较差异均有统计学意义(t值分别为5.76、5.91、5.37、12.86、5.07、2.54、5.33,P均＜0.05).(2)以是否合并NAFLD为因变量,以BMI、FINS、HOMA-IR、TG、LDL-C、HDL-C、UA为自变量,经Logistic回归分析显示BMI、HOMA-IR、TG是NAFLD的主要危险因素(OR值分别为2.838、19.241、2.019,P均＜0.05).结论新诊断2型糖尿病合并NAFLD患者存在更明显的脂代谢紊乱及胰岛素抵抗.肥胖、胰岛素抵抗、高TG是新诊断2型糖尿病患者发生NAFLD的危险因素.
목적 탐토신진단2형당뇨병(T2DM)합병비주정성지방간(NAFLD)환자적림상대사특점,병분석영향NAFLD적위험인소.방법 선택신진단적2형당뇨병환자142례,근거시부합병NAFLD분위A조(T2DM불합병NAFLD)(79례)、B조(T2DM합병NAFLD)(63례),소유수시자균측량신고、체질량급혈압,검측공복혈당(FPG)、혈지、뇨산(UA)、당화혈홍단백(HbA1c)、공복혈청이도소(FINS),계산체질량지수(BMI)、이도소저항지수(HOMA-IR),비교량조간림상급생화지표적특점.결과 (1)A、B량조적년령급혈압비교차이무통계학의의(P균＞0.05).B조BMI(26.79±1.93)kg/m2、FINS(15.49 ±2.44) mU/L、HOMA-IR(6.74±1.32)、감유삼지(TG) (2.94±0.65) mmol/L、저밀도지단백담고순(LDL-C)(3.46±0.73) mmol/L、UA(342.41 ±71.49) mmol/L균고우A조BMI(24.61±2.46) kg/m2、FINS(13.20±2.17) mU/L、HOMA-IR(5.65±1.10)、TG(1.74±0.46) mmol/L、LDL-C(2.78±0.86) mmol/L、UA(312.98 ±66.24) mmol/L,고밀도지단백담고순(HDL-C)(0.99±0.17)mmol/L저우A조(1.21±0.29) mm0l/L,량조비교차이균유통계학의의(t치분별위5.76、5.91、5.37、12.86、5.07、2.54、5.33,P균＜0.05).(2)이시부합병NAFLD위인변량,이BMI、FINS、HOMA-IR、TG、LDL-C、HDL-C、UA위자변량,경Logistic회귀분석현시BMI、HOMA-IR、TG시NAFLD적주요위험인소(OR치분별위2.838、19.241、2.019,P균＜0.05).결론신진단2형당뇨병합병NAFLD환자존재경명현적지대사문란급이도소저항.비반、이도소저항、고TG시신진단2형당뇨병환자발생NAFLD적위험인소.
Objective To explore metabolic characteristics of and risk factors for newly diagnosed type 2 diabetes mellitus(T2DM) combined with non-alcoholic fatty liver disease (NAFLD).Methods One hundred and forty-two cases of newly diagnosed T2DM were divided into two groups according to whether they have comorbid NAFLD:group A (without NAFLD,n =79) and group B (combined with NAFLD,n =63).Data collected included body height,body weight,blood pressure,fasting plasma glucose (FPG),blood lipid,serum uric acid (UA),HbA1c and fasting insulin,body mass index and insulin resistance index with homeostasis model(HOMA-IR) were calculated to compare the clinical and biochemical parameters between groups A and B.Results (1) The difference of age and blood pressure between groups A and B were not statistical different (P ＞ 0.05).Compared with group A,BMI ((26.79 ± 1.93) kg/m2 vs (24.61 ± 2.46) kg/m2,t =5.76),FINS((15.49±2.44) mU/L vs (13.20±2.17) mU/L),t =5.91),HOMA-IR((6.74± 1.32) vs (5.65 ±1.10),t =5.37),glycerin trimyristate (TG) ((2.94 ± 0.65) mmol/L vs (1.74 ± 0.46) mmol/L),t =12.86),low density lipoprotein cholesterin (LDL-C) ((3.46 ±0.73) mmol/L vs (2.78 ±0.86) mmol/L,t =5.07) and UA((342.41 ±71.49) mmol/L vs (312.98 ±66.24) mmol/L,t =2.54) were significantly higherand hight density lipoprotein cholesterin (HDL-C) ((0.99 ± 0.17) mmol/L vs (1.21 ± 0.29) mmol/L,t =5.33) was significantly lower in group B (P ＜ 0.05).(2) Using whether to combined with NAFLD as dependent variable,and BMI,FINS,HOMA-IR,TG,LDL-C,HDL-C and UA as independent variable,logistics regression analysis showed that BMI,HOMA-IR and TG were risk factors for NAFLD(OR =2.838,19.241,and 2.019 respectively,P ＜ 0.05).Conclusion Newly diagnosed type 2 diabetes mellitus combined with NAFLD have more obvious dyslipidemia and insulin resistance.Obesity,insulin resistance,hyper-triglyceridemia are risk factors for newly diagnosed type 2 diabetes mellitus combined with NAFLD.