摘要
目的:研究2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFL)与胰岛素抵抗(IR)、血脂紊乱、肥胖的关系及其发病的危险因素。方法:将符合标准的159例T2DM患者根据有无NAFL分为合并脂肪肝组与无脂肪肝组,分别记录维吾尔族和汉族患者身高(H)、体重(W)、腰围(WL)、血压(Bp)、血肌酐(Scr)、血尿酸(UA)、血脂、血清转氨酶、纤维蛋白原(FIB)及口服葡萄糖耐量试验(OGTT)的血糖与胰岛素水平,计算体重指数(BMI)及胰岛素抵抗指数(HOMA-IR)。通过非条件Logistic回归进行NAFL的危险因素分析。结果:T2DM合并脂肪肝组与无脂肪肝组相比较,BMI、WL及HOMA-IR明显增高(P<0.01);UA、甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FPG)及空腹血浆胰岛素(Fins)增高(P<0.05);Bp、Scr、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血清转氨酶、FIB、OGTT-2h血糖及OGTT-2h血浆胰岛素差异无统计学意义(P>0.05)。合并脂肪肝组中维吾尔族患者WL较汉族明显增加(P<0.01),而UA较汉族降低(P<0.05);无脂肪肝组中维吾尔族患者与汉族比较,WL明显增加(P<0.01),FPG及HOMA-IR增加(P<0.05)。WL及TG是NAFL的危险因素(P<0.01,OR值分别为1.055、2.358)。结论:T2DM合并NAFL患者存在明显的超重、中心性肥胖、血脂紊乱及IR,WL与TG是NAFL发病的危险因素。维吾尔族T2DM患者比汉族患者具有明显的中心性肥胖及其所引起的IR。
Objective： To investigate the relationship between insulin resistance （IR）, dyslipidemia, obesity and non alcoholic fatty liver （NAFL） in patients with T2DM, and the risk factors of NAFL. Methods： Ac cording to whether the patients had NAFL, 159 patients with T2DM consistent with the standard were divided into fatty liver group and non fatty liver group. Their body 17eight （H）, weight （W）, waistline （WL）, blood pressure （BP）, serum creatinine （Scr）, blood uric acid （UA）, blood fat, serum transaminase, serum fibrinogen （FIB）, serum glucose and insulin of OGTT test were recorded; body mass index （BMI） and insulin resistance index were calculated. And the Uygur nation was compared to the Han nation. The risk factor about NAFL was analyzed by Logistic regression. Results： The levels of BMI, WL and insulin resistance index increased significantly in fatty liver group compared with non-fatty liver group （P〈0.01）; the levels of UA, serum triglyceride （TG）, serum total cholesterol （TC）, fasting plasma glucose （FPG） and fasting serum insulin （Fins） increased in fatty liver group compared with non-fatty liver group （P 〈0.05）; the levels of Bp, Scr, serum high density lipoprotein （HDL）, serum low density lipoprotein （LDL）, serum transaminase, FIB, OGTT-2 h plasma glucose and OGTT-2h serum insulin had no statistical significance between two groups （P 〉0.05）. In fatty liver group, the level of WL of the Uygur nation significantly increased compared with the Han nation （P 〈0.01）; but the level of UA o.f the Uygur nation decreased compared with the Han nation （P 〈0.05）. In non fatty liver group, the level of WL of the Uygur nation significantly increased compared with the Han nation （P 〈0.01） ; the levels of FPG and insulin resistance index of the Uygur nation increased compared with the Han nation （P〈0.05）. WL and TG were the risk factors of NAFI.（P〈0.01, OR=1.055,2.358）. Conclusions： NAFI. in patients with T2DM had remarkable overweight, central obesity, dyslipidemia and IR; WI. and TG were the risk factors of NAFL. The Uygur nation patients had more obvious central obesity and IR than the Han nation patients.
出处
《新疆医科大学学报》
CAS
2008年第7期815-817,820,共4页
Journal of Xinjiang Medical University
