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2型糖尿病患者非酒精性脂肪肝与亚临床炎症因子的关系

宋旭臣1,王利霞2,张宏2,赵伟2,崔姗姗1   

  1. 1. 天津医科大学代谢病医院
    2. 天津医大代谢病医院
  • 收稿日期:2009-12-29 修回日期:2010-04-26 出版日期:2010-10-15 发布日期:2010-10-15
  • 通讯作者: 宋旭臣

Relationship between Nonalcoholic Fatty Liver Disease and Subclinial Inflammatory Factors in Patients with Type 2 Diabetes

  • Received:2009-12-29 Revised:2010-04-26 Published:2010-10-15 Online:2010-10-15

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2021

摘要： 摘要 目的：探讨2型糖尿病（DM）患者非酒精性脂肪肝（NAFLD）与血清超敏C反应蛋白（hs-CRP）、外周血白细胞计数（WBC）、血浆纤维蛋白原（FIB）水平的相关性。方法：我院住院的2型DM患者430例，根据腹部B超检查结果分为NAFLD组、非NAFLD组，分别检测、比较二组血清hs-CRP、外周血WBC计数、血浆FIB水平及其与NAFLD的相关性。结果：2型DM合并NAFLD组与非NAFLD组比较，血清hs-CRP、外周血WBC计数、血浆FIB水平显著升高（3.86±4.09vs2.41±3.48; 6.84±1.66vs6.42±1.70; 3.65±0.76vs3.42±0.81, P<0.05），单因素Logistic回归分析显示NAFLD与血清hs-CRP、外周血WBC计数、血浆FIB水平均存在显著正相关（OR=1.098，95%CI：1.038～1.163；OR=1.351, 95%CI：1.006～1.317; OR=1.395, 95%CI：1.063～1.831），调整了年龄、性别、DM病程、吸烟、血压、血脂、体质量指数（BMI）后，血清hs-CRP仍与NAFLD呈显著正相关（OR=1.197，95%CI：1.098～1.305）。结论：亚临床炎症因子，尤其血清hs-CRP与2型DM患者NAFLD的发生密切相关，改善2型DM患者的炎症状态将有助于NAFLD的防治。

关键词: 非酒精性脂肪肝, 糖尿病, 2型, 胰岛素抵抗, 白细胞, C反应蛋白, 纤维蛋白原

Abstract: Abstract Objective：To investigate the changes of the levels of high sensitivity reactive protein C (hs-CRP)，white blood cell(WBC) and fibrinogen(FIB) in Nonalcoholic Fatty Liver Disease (NAFLD) with type 2 Diabetes. Methods： Four hundred and thirty patients with type 2 diabetes were divided into NAFLD group and non-NAFLD group according to with or without NAFLD. The changes of the levels of hs-CRP，WBC and FIB in the two groups and the relationship between their levels and NAFLD were analyzed. Results：Compared to non-NAFLD group，the levels of hs-CRP，WBC，FIB in NAFLD group were increased obviously（3.86±4.09 vs2.41±3.48; 6.84±1.66vs6.42±1.70; 3.65±0.76vs3.42±0.81,P<0.05）.Using univariate logistic regression analysis it was found that NAFLD had a positive correlation with hs-CRP，WBC，FIB（OR=1.098，95%CI：1.038～1.163；OR=1.351, 95%CI：1.006～1.317; OR=1.395, 95%CI：1.063～1.831），In a multiple logistic regression analysis，after adjusting the age，gender，the ascend duration of diabetes，smoking , blood pressure, lipid and body mass index(BMI)，the levels of hs-CRP still had a predominant relation with NAFLD(OR=1.197，95%CI：1.098～1.305). Conclusion： Subclinial inflammatory factors, especially the levels of hs-CRP, are closely related with NAFLD.Changing the inflammatory condition of the patients with type 2 diabetes can be used for prevention and cure for NAFLD.

Key words: nonalcoholic fatty liver disease, diabetes mellitus, type 2, insulin resistence, white blood cell, hypersensitivity reactive protein C, fibrinogen