天津医药

天津医药 ›› 2014, Vol. 42 ›› Issue (12): 1219-1222.doi: 10.3969/j.issn.0253-9896.2014.12.019

• 临床研究 • 上一篇    下一篇

2型糖尿病合并高三酰甘油血症-腰围表型与非酒精性脂肪性肝病的相关性研究

丁炜光   

  1. 天津市南开区三潭医院
  • 收稿日期:2014-03-28 修回日期:2014-08-15 出版日期:2014-12-15 发布日期:2014-12-15
  • 通讯作者: 丁炜光 E-mail:angeltooxy@126.com

Association of hypertriglyceridaemic-waist phenotype with nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

  • Received:2014-03-28 Revised:2014-08-15 Published:2014-12-15 Online:2014-12-15

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摘要：

【 摘要】 目的 探讨 2 型糖尿病(T2DM)合并高甘油三酯血症-腰围表型（HTWC） 与非酒精性脂肪性肝病（NAFLD）之间的关系。 方法 选取 T2DM 患者 804 例， 以血三酰甘油≥1.7 mmol/L、腰围男性≥90 cm 或女性≥85 cm 为切点， 分为三酰甘油和腰围正常组、单纯高甘油三酯血症组、单纯腹型肥胖组、HTWC 组。 记录 4 组患者的一般临床资料， 计算体质指数（BMI）、 稳态模型评估的胰岛素抵抗指数（HOMA-IR） 和非酒精性脂肪肝纤维化指数（NAFLDFS）。 结果 HTWC 组患者平均 BMI、收缩压、舒张压、HOMA-IR、丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶、血尿酸、NAFLDFS 及 NAFLD 发病率均明显高于非 HTWC 组（ 均 P＜ 0.01）。 Logistic 回归分析显示， 除 BMI、 γ-谷氨酰转移酶、 血尿酸外， HTWC 也是 T2DM 患者合并 NAFLD 的危险因素（OR=1.986， 95%CI :1.006～ 3.921）。 结论 HTWC 是 T2DM 合并 NAFLD 的危险因素， 重视对 HTWC 表型者的早期筛查和诊断， 使患者尽早获得干预， 控制代谢紊乱， 有助于减少 NAFLD 的发生和延缓疾病的进展。

关键词: 脂肪肝, 糖尿病, 2 型, 非酒精性脂肪肝, 高甘油三酯血症-腰围表型

Abstract:

[Abstract] Objective To investigate the association of nonalcoholic fatty liver disease with hypertriglyceridaemic wasit phenotype complicated with type 2 diabetes mellitus. Methods Base on whether plasma triglycerides concentra?tion ≥1.7 mmol/L or not, waist circumference ≥90 cm or not in men or ≥85 cm or not in women, patients with type 2 diabe? tes mellitus (n=804) were divided into four groups: normal waist circumference with normal triglycerides, normal waist cir? cumference with hypertriglyceridemia, abdominal obesity with normal triglycerides and hypertriglyceridemic-waist pheno? type (HTWC). The four groups’ clinical data were recorded. Body mass index (BMI), homeostasis model assessment insulin resistance (HOMA-IR) and nonalcoholic fatty liver disease fibrosis score (NAFLDFS) were calculated and the results were compared among four groups. Results BMI, waist circumference, systolic blood pressure, diastolic blood pressure, HOMAIR, alanine aminotransferase, aspartate aminotransferase , γ-glutamyltransferase, serum uric acid， NAFLDFS and the inci? dence of NAFLD were all higher in the HTWC group compared to non-HTWC group (P＜ 0.01). Logistic regression analysis revealed that besides BMI， γ-glutamyltransferase and serum uric acid， HTWC was also a risk factor for NAFLD in patients with type 2 diabetes mellitus（OR=1.986， 95%CI:1.006-3.921）. Conclusion HTWC is a risk factor for NAFLD in patients with type 2 diabetes mellitus. Screening and diagnosis of HTWC is helpful for reducing the occurrence of NAFLD and can slow its progress through controlling and interfering metabolic disturbance.

Key words: fatty liver, diabetes mellitus, type 2, nonalcoholic fatty liver disease, hypertriglyceridaemic-waist phenotype