CAJ | 학술논문

目的：探讨2型糖尿病（T2DM）患者合并非酒精性脂肪肝（NAFLD）与骨密度（BMD）的相关性。方法筛选T2DM患者119例，依据B超结果分为2组： T2DM组（62例）， T2DM合并NAFLD组（57例）。测定正位腰椎2-4（ L2-4）、左侧股骨颈、 Ward's三角、大粗隆及左前臂骨密度，行肝脏彩超及血糖、血脂、空腹C肽、肝肾功能、尿微量白蛋白检测，测量身高、体重等。结果 T2DM合并NAFLD组患者体重指数、三酰甘油、总胆固醇、空腹C肽、谷氨酰转酞酶、尿酸、尿微量蛋白均高于T2DM组，差异有统计学意义（均P＜0.05）；左股骨颈、 Ward's三角和左前臂骨密度值低于T2DM组，差异有统计学意义（均P＜0.05）。 T2DM合并NAFLD与年龄、病程、左侧股骨和左前臂骨密度呈负相关（均P＜0.05），与体重指数、三酰甘油、总胆固醇、空腹C肽、尿微量蛋白呈正相关。左侧股骨颈骨密度值与年龄、病程、血糖、糖化血红蛋白A1 C、总胆固醇呈负相关（均P＜0.05），与体重指数、高密度脂蛋白、肌酐呈正相关（P＜0.05）。体重指数、三酰甘油、尿酸与NAFLD独立相关（ P＜0.05）。结论 T2DM合并NAFLD患者骨密度水平低于单纯2型糖尿病患者，二者有相关性。体重指数、空腹C肽、血脂是影响T2DM合并NAFLD患者骨密度水平的因素。
목적：탐토2형당뇨병（T2DM）환자합병비주정성지방간（NAFLD）여골밀도（BMD）적상관성。방법사선T2DM환자119례，의거B초결과분위2조： T2DM조（62례）， T2DM합병NAFLD조（57례）。측정정위요추2-4（ L2-4）、좌측고골경、 Ward's삼각、대조륭급좌전비골밀도，행간장채초급혈당、혈지、공복C태、간신공능、뇨미량백단백검측，측량신고、체중등。결과 T2DM합병NAFLD조환자체중지수、삼선감유、총담고순、공복C태、곡안선전태매、뇨산、뇨미량단백균고우T2DM조，차이유통계학의의（균P＜0.05）；좌고골경、 Ward's삼각화좌전비골밀도치저우T2DM조，차이유통계학의의（균P＜0.05）。 T2DM합병NAFLD여년령、병정、좌측고골화좌전비골밀도정부상관（균P＜0.05），여체중지수、삼선감유、총담고순、공복C태、뇨미량단백정정상관。좌측고골경골밀도치여년령、병정、혈당、당화혈홍단백A1 C、총담고순정부상관（균P＜0.05），여체중지수、고밀도지단백、기항정정상관（P＜0.05）。체중지수、삼선감유、뇨산여NAFLD독립상관（ P＜0.05）。결론 T2DM합병NAFLD환자골밀도수평저우단순2형당뇨병환자，이자유상관성。체중지수、공복C태、혈지시영향T2DM합병NAFLD환자골밀도수평적인소。
Objective To study the association of bone mineral density (BMD) between type 2 diabetes patients (T2DM) with nonalcoholic fatty liver disease (NAFLD).Methods 119 cases of T2DM selected on the basis of liver B-mode ultrasonography were divided into two groups: the former was T2DM group with 62 patients and the latter was NAFLD group with 57 patients.The BMD as lumbar vertebrae 1-4 and the femoral neck, Ward's triangle, Torch, left arm were asessed.Ultrasound measurement of liver was conducted and blood glucose (BG), blood lipid, C peptide (CP), the functions of liver and kidney , urine microalbumin (MAU), height and weight were measured .Results The 1evel of body mass index (BMI), triglyceride (TG), total cholesterol (TC), CP, glutamyl transpeptidase (GGT), uric acid (UA) and MAU in NAFLD group were significantly higher than that in T 2DM group (P<0.05).The BMD of femoral neck, Ward's tri and left arm was significantly lower than that in T2DM group (P <0.05).The regression analysis showed BMI, TG and UA were the independent influence factors of NAFLD .Conclusion T2DM combined with NAFLD had close relationship with BMD , BMD in patients with NAFLD and diabetes was lower than that in pure diabetes pa-tients.BMI, CP, blood lipid were factors that influence BMD in patients with T 2DM combined with NAFLD.