中国临床医学
中國臨床醫學
중국림상의학
Chinese Journal of Clinical Medicine
2015年
4期
531-535
,共5页
常薪霞%林寰东%张林杉%颜红梅%卞华%夏明锋%高鑫
常薪霞%林寰東%張林杉%顏紅梅%卞華%夏明鋒%高鑫
상신하%림환동%장림삼%안홍매%변화%하명봉%고흠
2 型糖尿病%非酒精性脂肪肝%高尿酸血症
2 型糖尿病%非酒精性脂肪肝%高尿痠血癥
2 형당뇨병%비주정성지방간%고뇨산혈증
Type 2 diabetes%Non-alcoholic fatty liver disease%Hyperuricemia
目的：：探讨2型糖尿病伴非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)对患者血尿酸水平的影响。方法：收集1651例住院2型糖尿病患者的临床资料,包括：既往史,如糖尿病病程、肝炎病史；人体学参数,如身高、体质量、腰围、臀围；生化指标,如血糖、糖化血红蛋白(glycosylated hemoglobin A1 c,HbA1 c)、血脂、相关肝酶、尿酸、尿素及肌酐等。应用彩色多普勒超声诊断脂肪肝。结果：2型糖尿病伴 NAFLD 者较不伴 NAFLD 者的血尿酸水平显著升高[(331.8±90.8)μmol/L 比(280.4±86.7)μmol/L,P <0.001],高尿酸血症检出率显著增加(21.3%比8.8%,P <0.001)。二元 logistic 回归分析显示,NAFLD(OR=2.508,95%CI ：1.403~4.486)及丙氨酸氨基转移酶(alanine aminotransferase,ALT；OR =5.396,95%CI ：2.481~11.733)、γ-谷氨酰转移酶(gamma-glutamyltransferase,GGT；OR =2.715,95%CI ：1.320~5.585)水平升高是2型糖尿病患者发生高尿酸血症的独立危险因素。结论：NAFLD 是2型糖尿病患者发生高尿酸血症的独立危险因素；血清 ALT 、GGT 水平升高也是2型糖尿病患者发生高尿酸血症的独立危险因素。
目的：：探討2型糖尿病伴非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)對患者血尿痠水平的影響。方法：收集1651例住院2型糖尿病患者的臨床資料,包括：既往史,如糖尿病病程、肝炎病史；人體學參數,如身高、體質量、腰圍、臀圍；生化指標,如血糖、糖化血紅蛋白(glycosylated hemoglobin A1 c,HbA1 c)、血脂、相關肝酶、尿痠、尿素及肌酐等。應用綵色多普勒超聲診斷脂肪肝。結果：2型糖尿病伴 NAFLD 者較不伴 NAFLD 者的血尿痠水平顯著升高[(331.8±90.8)μmol/L 比(280.4±86.7)μmol/L,P <0.001],高尿痠血癥檢齣率顯著增加(21.3%比8.8%,P <0.001)。二元 logistic 迴歸分析顯示,NAFLD(OR=2.508,95%CI ：1.403~4.486)及丙氨痠氨基轉移酶(alanine aminotransferase,ALT；OR =5.396,95%CI ：2.481~11.733)、γ-穀氨酰轉移酶(gamma-glutamyltransferase,GGT；OR =2.715,95%CI ：1.320~5.585)水平升高是2型糖尿病患者髮生高尿痠血癥的獨立危險因素。結論：NAFLD 是2型糖尿病患者髮生高尿痠血癥的獨立危險因素；血清 ALT 、GGT 水平升高也是2型糖尿病患者髮生高尿痠血癥的獨立危險因素。
목적：：탐토2형당뇨병반비주정성지방간병(non-alcoholic fatty liver disease,NAFLD)대환자혈뇨산수평적영향。방법：수집1651례주원2형당뇨병환자적림상자료,포괄：기왕사,여당뇨병병정、간염병사；인체학삼수,여신고、체질량、요위、둔위；생화지표,여혈당、당화혈홍단백(glycosylated hemoglobin A1 c,HbA1 c)、혈지、상관간매、뇨산、뇨소급기항등。응용채색다보륵초성진단지방간。결과：2형당뇨병반 NAFLD 자교불반 NAFLD 자적혈뇨산수평현저승고[(331.8±90.8)μmol/L 비(280.4±86.7)μmol/L,P <0.001],고뇨산혈증검출솔현저증가(21.3%비8.8%,P <0.001)。이원 logistic 회귀분석현시,NAFLD(OR=2.508,95%CI ：1.403~4.486)급병안산안기전이매(alanine aminotransferase,ALT；OR =5.396,95%CI ：2.481~11.733)、γ-곡안선전이매(gamma-glutamyltransferase,GGT；OR =2.715,95%CI ：1.320~5.585)수평승고시2형당뇨병환자발생고뇨산혈증적독립위험인소。결론：NAFLD 시2형당뇨병환자발생고뇨산혈증적독립위험인소；혈청 ALT 、GGT 수평승고야시2형당뇨병환자발생고뇨산혈증적독립위험인소。
Objective:To explore the impact of concomitant non-alcoholic fatty liver disease (NAFLD)of type 2 diabetes (T2DM)on patients’serum uric acid.Methods:Clinical data of 165 1 hospitalized patients with T2DM were collected,including the past medical history such as duration of diabetes and history of hepatitis,the morphological parameters such as height, weight,waistline and hipline,and the biochemical indexes such as blood glucose,glycosylated hemoglobin A1 c(HbA1 c),serum lipids,liver enzymes,uric acid,urea and creatinine.NAFLD was diagnosed by color doppler ultrasonography.Results:The se-rum uric acid level was significantly higher in T2DM patients accompanied with NAFLD than those without NAFLD(33 1 .8± 90.8 μmol/L vs.280.4±86.7 μmol/L,P <0.001 ),while detection rate of hyperuricemia significantly increased (21 .3% vs. 8.8%,P <0.001).Binary logistic regression analysis showed that NAFLD(OR=2.508,95%CI :1 .403-4.486),as well as the increase of serum levels of alanine aminotransferase(ALT;OR =5.396,95%CI :2.481-1 1 .733 )and gamma-glutamyltrans-ferase(GGT;OR=2.71 5,95%CI :1 .320-5.585),were independent risk factors of hyperuricemia for patients with T2DM. Conclusions:NAFLD is an independent risk factor of hyperuricemia for patients with T2DM.As markers of liver damage,the increase of serum levels of ALT and GGT is also an independent risk factor of hyperuricemiafor patients with T2DM.
