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目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并非酒精性脂肪肝(non alcoholic fatty liverdisease,NAFLD)的临床相关因素。方法:对新疆医科大学第五附属医院2008年1～6月的269例糖尿病住院患者进行回顾性分析,根据腹部B超结果分为合并NAFLD组148例,不合并NAFLD组121例。结果:与不合并NAFLD组比较,合并NAFLD的T2DM患者的体重指数(BMI)、腰围、血甘油三酯(TG)、低密度脂蛋白(LDL-C)、舒张压(DSP)显著增高(P均<0.05):同时高密度脂蛋白(HDL-C)显著降低(P<0.05);Logistic回归分析显示:BMI、DBP、TG、LDL-C、HDL-C对T2DM合并的NAFLD的发生有显著影响(P均<0.05)。结论:2型糖尿病患者合并非酒精性脂肪肝,与肥胖(主要是腹型肥胖)、血脂紊乱、血压增高相关;而与糖尿病病程、血糖控制程度、糖尿病并发症不相关,导致糖尿病合并非酒精性脂肪肝的最主要原因为胰岛素抵抗及其所包含的脂代谢紊乱。
Objective: To investigate the clinical factors of type 2 diabetes mellitus (T2DM) complicated with non alcoholic fatty liver disease (NAFLD). Methods: A retrospective analysis was performed on 269 hospitalized patients with diabetes mellitus in the Fifth Affiliated Hospital of Xinjiang Medical University from January to June in 2008. According to the results of abdominal ultrasonography, 148 cases were divided into NAFLD group and 121 cases without NAFLD group. Results: Body mass index (BMI), waist circumference, triglyceride (TG), low density lipoprotein (LDL-C) and diastolic pressure (DSP) were significantly higher in T2DM patients with NAFLD compared with those without NAFLD (P <0.05). Logistic regression analysis showed that BMI, DBP, TG, LDL-C and HDL-C had a significant effect on the incidence of T2DM complicated with NAFLD (All P <0.05). Conclusions: Type 2 diabetic patients with non-alcoholic fatty liver disease are associated with obesity (mainly abdominal obesity), dyslipidemia and high blood pressure, but not with diabetic course, blood glucose control and diabetic complications, resulting in diabetes mellitus complicated with non-alcoholic The main reason of fatty liver is insulin resistance and lipid metabolism disorder.