中国病案
中國病案
중국병안
CHINESE MEDICAL RECORD
2015年
4期
91-93
,共3页
张冬磊王%广徐%援杨%宁
張鼕磊王%廣徐%援楊%寧
장동뢰왕%엄서%원양%저
2型糖尿病%亚临床甲状腺功能减退症%非酒精性脂肪性肝病
2型糖尿病%亞臨床甲狀腺功能減退癥%非酒精性脂肪性肝病
2형당뇨병%아림상갑상선공능감퇴증%비주정성지방성간병
Type 2 diabetes mellitus%Subclinical hypothyroidism%Nonalcoholic fatty liver disease
目的：研究2型糖尿病合并亚临床甲状腺机能减退症(亚甲减)与非酒精性脂肪性肝病的关系。方法选择2013年1月-2013年6月某院2型糖尿病患者333例。将患者分为NAFLD组(210例)和非NAFLD组(123例)，对两组的血脂和胰岛素抵抗指标、生化肝功和甲状腺功能进行比较。还将患者分为甲状腺功能（甲功）正常组和亚甲减组，对两组合并非酒精性脂肪性肝病的比例进行比较。明确2型糖尿病合并非酒精性脂肪性肝病的危险因素。结果 NAFLD组的稳态模型胰岛素抵抗指数和促甲状腺激素分别为2.22(1.41,3.58)和2.32±1.93mIU/L，均明显高于非NAFLD组的1.05(0.71,1.60)和1.75±1.27mIU/L(P均＜0.01)。亚甲减组中非酒精性脂肪性肝病的患病率为87.5%(21/24)，明显高于甲功正常组的61.2%(189/309)(P=0.018)。身体质量指数、甘油三脂、稳态模型胰岛素抵抗指数和促甲状腺激素均是T2DM合并非酒精性脂肪性肝病的危险因素，比值比分别为1.127、1.453、1.985和1.248。结论2型糖尿病合并亚甲减患者中非酒精性脂肪性肝病的患病率明显高于甲功正常的患者，稳态模型胰岛素抵抗指数和促甲状腺激素升高均是2型糖尿病合并非酒精性脂肪性肝病的危险因素。
目的：研究2型糖尿病閤併亞臨床甲狀腺機能減退癥(亞甲減)與非酒精性脂肪性肝病的關繫。方法選擇2013年1月-2013年6月某院2型糖尿病患者333例。將患者分為NAFLD組(210例)和非NAFLD組(123例)，對兩組的血脂和胰島素牴抗指標、生化肝功和甲狀腺功能進行比較。還將患者分為甲狀腺功能（甲功）正常組和亞甲減組，對兩組閤併非酒精性脂肪性肝病的比例進行比較。明確2型糖尿病閤併非酒精性脂肪性肝病的危險因素。結果 NAFLD組的穩態模型胰島素牴抗指數和促甲狀腺激素分彆為2.22(1.41,3.58)和2.32±1.93mIU/L，均明顯高于非NAFLD組的1.05(0.71,1.60)和1.75±1.27mIU/L(P均＜0.01)。亞甲減組中非酒精性脂肪性肝病的患病率為87.5%(21/24)，明顯高于甲功正常組的61.2%(189/309)(P=0.018)。身體質量指數、甘油三脂、穩態模型胰島素牴抗指數和促甲狀腺激素均是T2DM閤併非酒精性脂肪性肝病的危險因素，比值比分彆為1.127、1.453、1.985和1.248。結論2型糖尿病閤併亞甲減患者中非酒精性脂肪性肝病的患病率明顯高于甲功正常的患者，穩態模型胰島素牴抗指數和促甲狀腺激素升高均是2型糖尿病閤併非酒精性脂肪性肝病的危險因素。
목적：연구2형당뇨병합병아림상갑상선궤능감퇴증(아갑감)여비주정성지방성간병적관계。방법선택2013년1월-2013년6월모원2형당뇨병환자333례。장환자분위NAFLD조(210례)화비NAFLD조(123례)，대량조적혈지화이도소저항지표、생화간공화갑상선공능진행비교。환장환자분위갑상선공능（갑공）정상조화아갑감조，대량조합병비주정성지방성간병적비례진행비교。명학2형당뇨병합병비주정성지방성간병적위험인소。결과 NAFLD조적은태모형이도소저항지수화촉갑상선격소분별위2.22(1.41,3.58)화2.32±1.93mIU/L，균명현고우비NAFLD조적1.05(0.71,1.60)화1.75±1.27mIU/L(P균＜0.01)。아갑감조중비주정성지방성간병적환병솔위87.5%(21/24)，명현고우갑공정상조적61.2%(189/309)(P=0.018)。신체질량지수、감유삼지、은태모형이도소저항지수화촉갑상선격소균시T2DM합병비주정성지방성간병적위험인소，비치비분별위1.127、1.453、1.985화1.248。결론2형당뇨병합병아갑감환자중비주정성지방성간병적환병솔명현고우갑공정상적환자，은태모형이도소저항지수화촉갑상선격소승고균시2형당뇨병합병비주정성지방성간병적위험인소。
Objective To profile the relationship between subclinical hypothyroidism(SHO) and nonalcoholic fatty liver disease(NAFLD) of patients with type 2 diabetes mellitus(T2DM).Methods From Jan 2013 to Jun 2013, 333 patients with T2DM admitted to our hospital were enrolled. Patients were divided into two groups: NAFLD group (210 patients) and non-NAFLD group(123 patients), blood lipid, insulin resistance indices, liver function, and thyroid function indices were compared. Also, patients were divided into 2 groups: euthyroid group and SHO group compared the incidence of NAFLD and found the risk factors of NAFLD in T2DM patients.Results Homeostasis model assessment-index of insulin resistance(HOMA-IR) and thyroid stimulating hormone(TSH) were significantly increased in NAFLD group than those in non-NAFLD group [2.22(1.41, 3.58) vs. 1.05(0.71, 1.60), 2.32±1.93mIU/L vs. 1.75±1.27mIU/L](P<0.01, respectively). Incidence of NAFLD in SHO group (21/24) was significantly higher than euthyroid group(189/309)(P=0.018). Body mass index, triglyceride, HOMA-IR and TSH were risk factors in T2DM with NAFLD, Odds ratio were 1.127, 1.453, 1.985 and 1.248, respectively.Conclusions NAFLD incidence in T2DM with SHO is significantly higher than that with euthyroid. Increased HOMA-IR and TSH are independent risk factors of NAFLD in T2DM patients.
