天津医药

• 短篇论著 • 上一篇    下一篇

299例脂肪肝病患者糖尿病发病情况5年随访

雷永富   

  1. 安徽省蚌埠市第一人民医院
  • 收稿日期:2012-05-03 修回日期:2012-10-15 出版日期:2013-02-15 发布日期:2013-02-15
  • 通讯作者: 雷永富

The incidence of diabetes in 299 cases of patients with fatty liver disease in the course of 5 years follow-up

  • Received:2012-05-03 Revised:2012-10-15 Published:2013-02-15 Online:2013-02-15

PDF (PC)

2414

摘要：

【摘要】目的 研究非酒精性脂肪肝病（NAFLD）患者随访5年期间的糖尿病发病情况。方法 选择2005年1 月—2006年12月在本院初次体检，2011年12月前再次体检且资料完整的110例为研究对象。全部研究对象均由专业医务人员行常规体检，测空腹血糖、血脂及胰岛素等指标，行心电图及肝脏彩超检查；以初次体检肝脏彩超诊断结果为分组标准，肝脏彩超检查发现肝脏有脂肪肝改变者为NAFLD组，彩超提示肝脏无异常者为对照组。基线状态的胰岛素水平分为<10 mU/L、10~15 mU/L及>15 mU/L 3个水平，分析基线状态NAFLD与对照组之间胰岛素水平的差异及5年间不同胰岛素水平状态下NAFLD组与对照组间糖尿病检出率的变化。结果 基线状态彩超诊断NAFLD 299 例（27.16%）。NAFLD组基线状态高胰岛素血症患者所占比例较高（P < 0.01）。5年间11.08%的研究对象发展为糖尿病，NAFLD组18.7%明显高于对照组8.2%（P < 0.01）；在胰岛素水平>15 mU/L亚组，NAFLD患者的糖尿病检出率 21.2%高于对照组13.8%（P <0.05）；在NAFLD组内，>15 mU/L亚组的糖尿病检出率高于其他亚组（P < 0.01）；在对照组内，胰岛素水平>15 mU/L 亚组的糖尿病检出率13.8%明显高于<10 mU/L亚组5.9%（P < 0.05）。结论NAFLD患者有更高的糖尿病发病风险，可能与胰岛素抵抗有关。

关键词: 脂肪肝病, 糖尿病, 检出率, 5年随访

Abstract: Object: Explore the incidence of diabetes in patients fatty liver disease at followed-up 5 years. Method: he crowd was used as the research objects who their first medical examination were performed during 2005.1-2006.12.in our hospital, the examining again before 2011.12.and having complete data, eliminating individuals with HBSAg (+), blood glucose abnormalities and massive alcohol intake. Some index were measured in all participants including height, weight, blood pressure, BMI, fasting blood sugar and blood fat, liver function and insulin levels, electrocardiogram and liver ultrasonography inspection. The objects were divide into the fatty liver disease group and the non fatty liver disease group according to liver ultrasonography inspection results at baseline levels, the insulin concentrations were divided into three levels:< 10ulu/ml, 10-15ulu/ml and >15ulu/ml. Comparison the change of the above indexes and incidence of diabetes between the two groups at follow-up 5 years. Result: (1) The incidence of fatty liver disease was 27.16% by color dopplar ultrasound diagnosis in our data at Baseline level. (2) There were statistically significant differences on age, gender, BMI, blood pressure, blood fat and blood sugar, ALT and AST between the two groups; the fasting insulin concentrations of the majority individuals were >15ulu/ml in fatty liver disease group , it were <10ulu/ml in non fatty liver disease group at Baseline level. (3) The total incidence of diabetes was 10.53% at 5 years of follow-up, having higher incidence of diabetes compared with general population, it was higher in the fatty liver disease group (16.7% vs 8.2%) with statistically significant. (4)Further analysis shows that there were the highest incidence of diabetes in fatty liver disease group with insulin >15ulu/ml level and it was the lower in non fatty liver disease group with insulin levels<10ulu/ml. At the same insulin levels, the incidence of diabetes was higher in fatty liver disease group. with insulin levels rise, the diabetes rate increases, the related analysis shows the difference having statistically significant. Conclusion: The fatty liver disease may involve in the course of adjusting the risk of developing diabetes in individual with insulin resistance.

Key words: fatty liver disease, diabetes, incidence, 5 years follow-up