2型糖尿病合并非酒精性脂肪肝相关危险因素分析(1)
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[摘要] 目的:探讨影响2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFL)的相关危险因素。方法:45例老年T2DM患者根据B超检查结果,分为T2DM合并NAFL组(A组,23例)与T2DM无脂肪肝组( B组,25例) , 对两组患者的身高、体重、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、APO-A1、APO-B等指标进行测定分析,行肝脏超声检查,计算血浆致动脉粥样硬化指数(AIP)、体重指数(BMI)、APO-A1/APO-B。结果:A组与B组比较,SBP、DBP、BMI、TG、AIP水平明显升高(P<0.05或P<0.01),APO-A1水平明显降低,两组FPG、2 h PG、HDL-C、APO-B水平、APO-A1/APO-B值差异无显著性(P>0.05)。结论:2型糖尿病合并非酒精性脂肪肝与高血压、HbA1c升高、脂代谢紊乱及肥胖等有关。
[关键词]2型糖尿病;非酒精性脂肪肝;糖化血红蛋白;脂代谢紊乱;肥胖
[中图分类号] R587.1[文献标识码]A[文章编号]1673-7210(2009)06(b)-023-02
Analysis of correlated risk factors of type 2 diabetes associated with nonalcoholic fatty liver
YANG Hongying, CHEN Nuoqi, CHEN Jinfeng
(Department of Endocrinology, the Affiliated Zhangzhou Hospital of Fujian MedicalUniversity, Zhangzhou363000,China)
[Abstract] Objective: To explore the correlated risk factors associated with type 2 diabetes complicated with nonalcoholic fatty liver. Methods:48 patients with type 2 diabetes were divided into two groups according to whether the patients presented with fatty liver or not. Height and weight, SBP, DBP, FPG, 2 hPG, HbA1c, blood lipid(TG, TC, LDL-C, HDL-C,APO-A1, APO-B)level were measured and AIP, BMI, APO-A1/APO-B was calculated in 23 cases of type 2 diabetes patients complicated with nonalcoholic fatty liver(group A). 25 cases of type 2 diabetes patients without nonalcoholic fatty liver(group B)were taken as control.Results:SBP, DBP, HbA1c, BMI, triglycerides(TG) and AIP are higherbut APO-A1 is lower in group A than that in group B(P<0.05 or P<0.01).There are not significant differences between A and B groups on FPG, 2 h PG, HDL-C, APO-B, APO-A1/APO-B(P>0.05).Conclusion: Type 2 diabetes complicated with nonalcoholic fatty liver is related to dyslipidemia, high blood glucose and obesity.
脂肪肝是一种十分常见的肝脏疾病,在我国T2DM合并脂肪肝占NAFL较大比例。流行病学研究表明,脂肪肝在一般人群中的发病率为1%~9%[1] 。James等[2]报道美国糖尿病患者伴有脂肪肝的发病率在20世纪80年代约为30%,而在90年代上升到了40%。在国内,脂肪肝已成为仅次于病毒性肝炎的第二大肝病。脂肪肝患者可以从单纯的脂肪肝转变为肝纤维化、肝硬化,甚至可进展为肝功能衰竭而需肝移植治疗。因此,脂肪肝越来越受重视。本文通过多因素分析,探讨与T2DM合并NAFL的发生和发展有关的危险因素。
1 资料与方法
1.1 临床资料
1.1.1 入选标准收集2004年1月~2005年12月在我院住院的T2DM患者48例,符合1999年WHO糖尿病诊断标准 ......
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