【摘要】 目的探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的危险因素及其与胰岛素抵抗的关系。方法将246例T2DM患者根据是否合并NAFLD分为观察组(108例)与对照组(138例),对比两组患者性别、年龄、空腹血糖(FBG)、空腹血胰岛素(FINS)、体质指数(BMI)、腰臀比(WHR)、糖尿病病程、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(Hb Alc)、胰岛素抵抗指数(HOMA-IR),并将具有统计学差异的指标进行多因素Logistic回归分析,同时采用超声进行肝脏检查,分析肝脏超声评分与HOMA-IR的相关性。结果两组患者性别、年龄、FBG、FINS、HDL比较差异均无显著性(P>0.05),BMI、WHR、糖尿病病程、ALT、AST、TC、TG、LDL、Hb Alc、HOMA-IR比较差异显著(P<0.01)。Logistic回归分析显示,BMI、TG、LDL、Hb Alc以及HOMA-IR均为T2DM患者合并NAFLD的独立危险因素(P<0.05或P<0.01)。结论 HOMA-IR与NAFLD的超声评分呈显著正相关,研究结果提示HOMA-IR能够反映T2MD患者合并NAFLD的风险,有助于患者病情的评估。更多还原

【Abstract】 Objective To discuss the related factors of patients with type 2 diabetes melitus(T2DM) and nonalcoholic fatty liver disease(NAFLD) and analyzed the relationship with insulin resistance. Method 164 patients with T2 DM were divided into observation group(108 cases) and control group(138 cases) according to whether with NAFLD, and then gender, age, BMI, WHR, duration of diabetes, ALT, AST, TG, TC, LDL, HDL, Hb Alc, FBG, FINS and HOMA-IR were contrasted between two groups, and positive factor were analyzed with Logistic regression analysis, and liver were detected with ultrasound, then the relationship between ultrasound score of liver and HOMA-IR were analyzed. Result There were no significant difference between two groups in sex, age, FBG, FINS, HDL(P > 0.05); comparison of significant differences in BMI, WHR, duration of diabetes, ALT, AST, TC, TG, LDL, Hb Alc, HOMA-IR(P < 0.01). Logistic regression analysis showed that, BMI, TG, LDL, Hb Alc and HOMA-IR were independent risk factors are of T2 DM patients with NAFLD(P < 0.05 or P < 0.01). Conclusion HOMA-IR and NAFLD ultrasound scores show a significant positive correlation, results suggest that HOMA-IR can reflect T2 MD risk patients with NAFLD, and help to assess the patient’s condition.更多还原