天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (1): 74-77.doi: 10.3969/j.issn.0253-9896.2015.01.020

• 临床研究 • 上一篇    下一篇

糖尿病非肥胖人群腰围与新发非酒精性脂肪肝的关系#br#

杨春伟 1， 刘星 2， 刘秀荣 2， 王晓涛 3， 张景义 1， 闫秀纵 4， 周艳茹 1， 陈朔华 5， 曹正新 2， 吴寿岭 6△#br#   

  1. 1 河北联合大学附属开滦总医院内分泌科（邮编 063000）； 2河北联合大学附属开滦总医院体检中心； 3 河北联合大学附属医院普外科；4河北联合大学附属开滦总医院重症监护科；5 开滦医疗集团员工健康保障中心；6河北联合大学附属开滦总医院心内科
  • 收稿日期:2013-11-15 修回日期:2014-08-11 出版日期:2015-01-15 发布日期:2015-01-30
  • 通讯作者: 吴寿岭E-mail： drwusl@163.com E-mail:13102606749@163.com
  • 作者简介: 杨春伟（1978）， 女， 硕士， 主要从事糖尿病及肥胖相关性研究

The relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus

YANG Chunwei1, LIU Xing2, LIU Xiurong2， WANG Xiaotao3, ZHANG Jingyi1, YAN Xiuzong4, ZHOU Yanru1,#br# CHEN Shuohua5, CAO Zhengxin2, WU Shouling6△#br# #br#   

  1. 1 Department of Endocrinology, Affiliated Tangshan Kailuan General Hospital, Hebei 063000, China; 2 Department of Physi? cal Examination, Affiliated Tangshan Kailuan General Hospital; 3 Department of Surgery, Affiliated Hebei United University Hospital; 4 Department of ICU, Affiliated Tangshan Kailuan General Hospital; 5 Kailuan Medical Group; 6 Department of Cardiology, Affiliated Tangshan Kailuan General Hospital
  • Received:2013-11-15 Revised:2014-08-11 Published:2015-01-15 Online:2015-01-30
  • Contact: E-mail： drwusl@163.com E-mail:13102606749@163.com

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摘要： 摘要： 目的 探讨糖尿病非肥胖人群腰围增加与新发非酒精性脂肪肝之间的关系。 方法 采用前瞻性队列研究方法， 选取空腹血糖≥7.0 mmoL/L 或<7.0 mmoL/L 但既往已被确诊为糖尿病并使用降糖药物且体质指数（BMI）< 25 kg/m2者 1 950 例， 依据基线腰围分为 5 组， 腰围＜ 78 cm 为 A 组（387 例）； 78 cm≤腰围＜ 82 cm 为 B 组（377 例）； 82 cm≤腰围＜ 85 cm 为 C 组（307 例）； 85 cm≤腰围＜ 90 cm 为 D 组（458 例）； 腰围≥90 cm 为 E 组（421 例）。 应用多重 Logistic 回归模型分析影响糖尿病非肥胖人群新发脂肪肝的影响因素。 结果 观察队列的平均随访时间为（47.24±5.13)个月 ， 至 2010 年度查体时， 非酒精性脂肪肝的发病率为 11.85%（231/1 950）， A、B、C、D、E 组发病率依次为 6.98%、9.28%、12.38%、14.19%、15.68%， 其随腰围水平的增加而依次升高（P＜ 0.05）。 在多重 Logistic 回归模型分析中， 与 A 组比较， 总人群 D、E 组的 OR 值分别为 1.97、2.19（P＜ 0.05）。 结论 糖尿病非肥胖人群腰围≥85 cm 是新发非酒精性脂肪肝的危险因素。

关键词: 糖尿病, 队列研究, Logistic 模型, 非酒精性脂肪肝, 腰围

Abstract: Abstract： Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non- obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, whodetermined fasting plasma glucose（FPG） ≥7.0 mmol/L or who were using hypoglycemic drugs and FPG < 7.0 mmol/L， and body mass index (BMI) < 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non- obese patients with diabetes mellitus. Re⁃ sults The average duration of follow-up was（47.24±5.13) months. The incidence rate was 11.85% (231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19% and 15.68% in A, B, C, D and E groups, and which were increased with the increased waist circumference (P＜ 0.05). Results of multiple Logistic re⁃ gression model analysis showed that compared with A group， OR values were 1.97 and 2.19 in D and E groups respectively （P＜ 0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.

Key words: diabetes mellitus, cohort studies, Logistic models, non-alcoholic fatty liver disease, waist circumference