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目的观察30岁以下既往无糖尿病的非酒精性脂肪性肝病男性患者口服糖耐量试验,预测NAFLD与临床前期糖尿病的相关性。方法选择52例合并丙氨酸氨基转移酶升高的NAFLD年青男性患者,所有患者均行75g标准口服糖耐量实验,空腹血糖受损是指空腹血糖水平≥6.1mmol/L但<7mmol/L,糖耐量异常是指餐后2h血糖水平≥7.8mmol/L但<11.1mmol/L。结果 11(21%)名患者被诊断为空腹血糖受损,18(35%)名患者被诊断为糖耐量异常,6(12%)名患者被诊断为糖尿病,17(33%)名患者糖耐量正常。与糖代谢正常的NAFLD患者相比,体重指数、腰围、转氨酶水平、总胆红素、总胆固醇、甘油三酯、空腹血糖、HOMA-IR均有显著差异。结论建议对合并丙氨酸氨基转移酶升高的非酒精性脂肪肝患者,即使是年青病人,亦应行口服糖耐量实验来预测2型糖尿病的危险性。
Objective To observe the oral glucose tolerance test of non-alcoholic fatty liver disease patients under 30 years of age with non-diabetic fatty liver disease and to predict the association between NAFLD and preclinical diabetes mellitus. Methods Fifty-two young male patients with elevated alanine aminotransferase (ALT) were enrolled in this study. All patients underwent standard oral glucose tolerance test (75g). Impaired fasting glucose (FPG) level was ≥6.1mmol / L but <7mmol / L, Impaired glucose tolerance refers to 2h postprandial blood glucose levels ≥ 7.8mmol / L but <11.1mmol / L. Results Eleven (21%) patients were diagnosed as impaired fasting glucose, 18 (35%) were diagnosed with impaired glucose tolerance, 6 (12%) were diagnosed with diabetes, and 17 (33% Normal tolerance. Body mass index, waist circumference, aminotransferase levels, total bilirubin, total cholesterol, triglycerides, fasting glucose, and HOMA-IR were significantly different from those with normal glucose metabolism. Conclusion It is suggested that patients with non-alcoholic fatty liver disease with elevated alanine aminotransferase should be given oral glucose tolerance test to predict the risk of type 2 diabetes even in younger patients.