2型糖尿病伴非酒精性脂肪肝与胰岛素抵抗及血脂异常的研究

摘要

Objective:To explore the relationship between insulin resistance(IR) and dyslipidemia in type 2 diabetes mellitus (T2DM) associated with nonalcoholic fatty liver(NAFLD). Methods: Sixty-eight patients with T2DM were randomly divided into fatty liver group (DF group) with 38 cases and non-fatty liver group (NDF group) with 30 cases. Blood lipid, blood glucose, fasting and 2-hour serum insulin, and liver and kidney function were detected. Body weight index (BMI), waist-hip ratio (WHR) and insulin resistance index( HOMA-IR) were calculated and compared between the two groups. Results: The average levels of TG, LDL-C, Fins, 2hlns, BMI, WHR, HOMA-IR, ALT and AST in fatty liver group were significantly higher than those in non-fatty liver group, while the level of HDL-C was significant lower than that in non-fatty liver group. But there were no significant difference for FPG, 2hPG and HbAlc between the two groups. Conclusion: T2DM patients complicated with NAFLD have more obvious insulin resistance and lipid metabolism.%目的:探讨2型糖尿病(T2DM)伴非酒精性脂肪肝(NAFLD)与胰岛素抵抗(IR)及血脂异常的关系.方法:随机选取T2DM患者68例,按是否并发NAFLD分为脂肪肝组38例和非脂肪肝组30例,测定两组患者的甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)及餐后2h血浆胰岛素(2hIns),计算并比较两组之间的体重指数(BMI)、腰臀比(WHR)以及胰岛素抵抗指数(HOMA-IR).同时检测肝功能.结果:脂肪肝组TG、LDL-C、Fins、2hIns、BMI、WHR、HOMA-IR、ALT、AST的平均水平均显著高于非脂肪肝组,而HDL-C则显著低于非脂肪肝组.两组FPG、2hPG及HbA1c水平则无显著差异.结论:T2DM伴NAFLD患者存在着明显的胰岛素抵抗及脂质代谢异常.