目的 探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的相关因素,并分析其与胰岛素抵抗的关系.方法 164例T2DM患者根据是否合并NAFLD分为观察组(合并NAFLD,n=72)与对照组(不合并NAFLD,n=92),比较两组患者性别、年龄、体质量指数(BMI)、腰臀比(WHR)、糖尿病病程、肝功能、血脂、糖化血红蛋白(HbAlc)、血糖、胰岛素以及胰岛素抵抗指数(HOMA-IR)之间的差异,并分析T2DM合并NAFLD与胰岛素抵抗之间的关系.结果 观察组的BMI、WHR、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、HbAlc及HOMA-IR均明显高于对照组,糖尿病病程长于对照组,差异均有统计学意义(P<0.05),而在性别、年龄、HDL-C、FBG及FINS方面比较差异均无统计学意义(P>0.05);观察组不同程度脂肪肝患者HOMA-IR与肝脏B超评分呈显著正相关(r=0.724,P<0.05).结论 T2DM患者合并NAFLD主要与BMI、WHR、糖尿病病程、ALT、AST、TC、TG、LDL-C、HbAlc以及HOMA-IR相关,且NAFLD病情严重程度与HOMA-IR呈显著正相关.%Objective To discuss the related factors of patients with ype 2 diabetes mellitus (T2DM) compli-cating non-alcoholic fatty liver disease (NAFLD) and analyzed the correlation of the complication with insulin resis-tance. Methods According to whether with NAFLD, 164 patients with T2DM were divided into the observation group (with NAFLD, n=72) and the control group (without NAFLD, n=92). Then gender, age, body mass index (BMI), waist-hip ratio (WHR), duration of diabetes, liver function, blood lipid, HbAlc, blood glucose, insulin and HOMA-IR were compared between the two groups. The relationship between the complication and insulin resistance was analyzed. Results The BMI, WHR, alanine aminotransferase (ALT), glutamic-oxaloacetic transaminase (AST), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), HbAlc, and HOMA-IR in the ob-servation group were significantly higher than those in the control group (P<0.05), and duration of diabetes was signif-icantly longer than that in the control group (P<0.05). No significant difference was found in gender, age, HDL-C, FBG, and FINS between the two groups (P>0.05). HOMA-IR and liver ultrasound score had a significantly positive correlation in patients with different levels of fatty liver in the observation group (r=0.724, P<0.05). Conclusion Pa-tients with T2DM complicating NAFLD are related with BMI, WHR, duration of diabetes, ALT, AST, TC, TG, LDL-C, HbAlc, and HOMA-IR, and the severity of NAFLD has significantly positive correlation with HOMA-IR.
展开▼
