2型糖尿病患者非酒精性脂肪肝病与颈动脉硬化及危险因素的相关分析

摘要

目的:观察2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者的肝脏超分级与动脉粥样硬化及危险因素的关系.方法:52例2型糖尿病患者经彩色超声检查后分为三组:A组54例为不伴非酒精性脂肪肝病,B组46例伴轻度非酒精性脂肪肝病,C组52例伴中、重度非酒精性脂肪肝病,分别测定平均颈动脉IMT、HOMA-IR、HbA1c、血脂、体重指数(BMI),并进行比较.结果:三组患者均值间差别均有显著性意义(P<0.05);与不伴非酒精性脂肪肝病患者相比,NAFLD患者颈动脉内膜中层厚度增加更明显(各组P<0.05),颈动脉内膜的厚度与NAFLD的分级增加呈正相关.结论:2型糖尿病(T2DM)合并NAFLD患者胰岛素抵抗增强,颈动脉内膜中层厚度(IMT)增加,发生动脉粥样硬化的风险增加.%Objective:To evaluate whether NAFLD is associated with atherosclerosis and its risk factors in type 2 diabetic subjects. Methods:Total 152 T2DM patients were examined by color Dopplersonography, and they were divided into group A (54 subject s without NAFLD), group B (46 subjects with mild NAFLD), group C 52 subjects with moderate - severe NAFLD). Carotid IMT were measured by ultrosonography in all subjects, their HbAlc, plasma lipids and insulin resistance index (HOMA- IR) were also measured and analyzed. Results:There were significant differences in ALT, BMI and HOMA - IR, TG, TC, LDL-C, in three groups (P<0.05). The difference in carotid IMT between the control group without NAFLD, the mild group and the moderate - severe group was significant (P<0.05). Moreover, carotid IMT was positively associated with degree of hepatic steatosis However. Conclusion:Increased Carotid IMT and IR is observed among TDM subjects with NAFLD, and the risk of developing atherosclerosis is increased.