2型糖尿病合并非酒精性脂肪肝与慢性肾脏疾病的关系

摘要

目的 探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)与慢性肾脏疾病(CKD)的关系.方法 选取300例T2DM患者,按是否合并NAFLD将患者分为T2DM未合并NAFLD组(A组)及T2DM合并NAFLD组(B组).比较两组患者的一般资料及实验室检查结果,然后将差异有统计学意义的因素作为自变量,将CKD作为因变量进行多元Logistic回归分析.结果 300例T2DM患者中,A组131例(43.7%),B组169例(56.3%).B组患者的腰臀比、胰岛素抵抗指数(HOMA-IR)、丙氨酸氨基转移酶酶(ALT)、天冬氨酸氨基转移酶(AST)显著高于A组,而高密度脂蛋白胆固醇(HDL-C)水平显著低于A组,差异均有统计学意义(P＜0.05).多元Logistic回归分析显示,NAFLD是T2DM患者发生CKD的独立危险因素[OR=1.032,95%CI(1.012,1.052)].结论 NAFLD与CKD密切相关,故早期诊断和干预NAFLD有可能会预防CKD的发生、发展.%Objective To investigate the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) in type 2 diabetic (T2DM) patients. Methods A total of 300 T2DM inpatients were selected and were divided into group A and group B according to the presents of NAFLD. The general information and laboratory data of the two groups were compared, and factors with statistically significant differences between the two groups were taken as independent variable and CKD was taken as dependent variable. Then multivariate logistic regression analysis was conducted. Results There were 131 cases in group A (43. 7%) and 169 cases in group B (56. 3%). The waist to hip ratio (WHR), homeostasis model assessment-IR (HOMA-IR), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of group B were significantly higher than those of group A, but high density lipoprotein cholesterol (HDL-C) was significantly lower than that of group A (P <0. 05). Multivariate logistic regression analysis showed that NAFLD was the independent risk factor for CKD a-mong T2DM patients [ OR = 1. 032, 95% CI (1. 012, 1. 052) ]. Conclusion NAFLD is closely related to CKD in type 2 diabetic patients. Early identification and intervention of NAFLD may prevent the occurrence and development of CKD.