2型糖尿病患者非酒精性脂肪肝病与血清尿酸水平相关性的研究

摘要

目的 探讨T2DM患者非酒精性脂肪肝病(NAFLD)与SUA水平的相关性. 方法 选取T2DM患者790例,检测临床实验指标,采用腹部彩色多普勒超声检查诊断NAFLD.根据是否合并NAFLD分为合并NAFLD (NAFLD)组219例和未合并NAFLD(N-NAFLD)组571例；根据SUA水平分为4组:Q1组202例(≤230 μmol/L)、Q2组194例(231～287μmol/L)、Q3组194例(288～350 μmol/L)和Q4组200例(≥351 μmol/L). 结果 NAFLD组BMI、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、TG、TC、LDL-C和SUA等均高于N-NAFLD组(P均＜0.05)；NAFLD组年龄和HDL-C低于N-NAFLD组(P均＜0.05)；其余指标两组间差异无统计学意义(P＞0.05).Q1～4组T2DM患者合并NAFLD的患病率分别为16.8％(34/202)、22.6％(44/194)、30.9％(60/194)和40.5％(81/200),4组间差异有统计学意义(x2=31.71,P＜0.001);校正相关因素后,Q4组NAFLD患病风险仍高于Q1组(OR 3.19,95％CI 1.38～7.39). 结论 T2DM患者NAFLD与SUA有相关性,高SUA水平可能是T2DM患者NAFLD发生的独立相关因素.%Objective To investigate the relationship between serum SUA levels and non-alcoholic fatty liver disease (NAFLD) in T2DM patients. Methods A total of 790 T2DM subjects were enrolled in this study. Clinical experimental indices were detected. The abdominal Doppler ultrasonic examination was applied for diagnosis of NAFLD. The patients were divided into NAFLD group (n=219) and non-NAFLD group (n=571). According to the SUA levels (μmol/L) with quartiles grouping, the patients were divided into four SUA groups: Q1 group (≤230 μmol/L, n=202), Q2 group (231~287 μmol/L, n=194), Q3 group (288 ~ 350 μmol/L, n=194), and Q4 group (≥350, n = 200). Results BMI, ALT, AST, γ-glutamyltransferase (GGT), TC, TG, LDL-C, and SUA were significantly higher in the NAFLD group than in the non-NAFLD group (P<0. 05). The age and HDL-C in the NAFLD group were significantly lower than in the non-NAFLD group (P<0. 05). There were no statistical differences of other indexes between them. The prevalence of NAFLD in Q1~Q4 groups was 16. 8% (34/202), 22. 6% (44/194), 30. 9% (60/194) and 40. 5% (81/200) respectively, and the differences among the four groups were statistically significant After adjusting the related factors, the risk for prevalence of NAFLD in Q4 group was still significantly higher than that in Q1 group [OR (95%CI) :3.19 (1. 38~7. 39)]. Conclusion The serum uric acid level in subjects with T2DM was significantly related with NAFLD. A higher SUA level may be one of the factors independently related to NAFLD in T2DM patients.