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目的探讨血清尿酸(SUA)水平对新诊断T2DM患者非酒精性脂肪性肝病(NAFLD)的影响。方法选取新诊断T2DM住院患者523例,其中不伴NAFLD患者(Non-NAFLD组)131例,伴NAFLD患者(NAFLD组)392例;按SUA水平分为SUA<360μmol/L(N-SUA组)436例,SUA≥360μmol/L(H-SUA组)87例。分别比较两组一般临床指标、SUA、肝功、血脂、血糖、C-P、胰岛素抵抗指数(HOMA-IR)并行相关性分析。结果与Non-NAFLD组比较,NAFLD组SUA水平、SBP、WC、臀围、WHR、体重、谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)、TC、TG、LDL-C、FC-P、2hC-P、HOMA-IR升高(P<0.05或P<0.01)。在男性新诊断T2DM患者中,H-SUA组和N-SUA组NAFLD的发生率分别为87.9%、71.3%(P<0.05);在女性新诊断T2DM患者中,H-SUA组和N-SUA组NAFLD的发生率分别为87.4%、75.5%(P>0.05);Logistic回归分析显示,高SUA水平是新诊断T2DM患者伴NAFLD的独立危险因素(OR=1.003,95%CI:1.000~1.007,P<0.05)。SUA水平预测新诊断T2DM合并NAFLD的受试者工作特征(ROC)曲线下面积为0.646(95%CI:0.594~0.697),当SUA水平≥276.55μmol/L时有最大敏感性(52%)和特异性(69.5%)。结论新诊断T2DM患者NAFLD的发生与SUA水平有相关性,高SUA是新诊断T2DM患者发生NAFLD的独立危险因素。
Objective To investigate the effect of serum uric acid (SUA) on non-alcoholic fatty liver disease (NAFLD) in newly diagnosed T2DM patients. Methods A total of 523 newly diagnosed T2DM patients were enrolled. Among them, 131 cases were non-NAFLD patients (NAFLD group) and 392 cases were NAFLD patients (NAFLD group), SUA was lower than 360μmol / L (N-SUA group) 436 cases, SUA≥360μmol / L (H-SUA group) 87 cases. The clinical data of SUA, liver function, blood lipids, blood glucose, C-P, and insulin resistance index (HOMA-IR) were compared between the two groups. Results Compared with Non-NAFLD group, SUA level, SBP, WC, hip circumference, WHR, body weight, AST, ALT, TC, TG , LDL-C, FC-P, 2hC-P and HOMA-IR (P <0.05 or P <0.01). Among the newly diagnosed T2DM patients, the incidences of NAFLD in H-SUA group and N-SUA group were 87.9% and 71.3%, respectively (P <0.05) The incidence of NAFLD was 87.4% and 75.5% respectively (P> 0.05). Logistic regression analysis showed that high SUA level was an independent risk factor for newly diagnosed T2DM patients with NAFLD (OR = 1.003, 95% CI: 1.000-1.007, P <0.05). The area under the receiver operating characteristic (ROC) curve for newly diagnosed T2DM with NAFLD was 0.646 (95% CI: 0.594 to 0.697) for SUA level prediction and 52% for SUA levels (≥276.55 μmol / L) Specificity (69.5%). Conclusion The occurrence of NAFLD in newly diagnosed T2DM patients is correlated with SUA level. High SUA is an independent risk factor for newly diagnosed NAFLD in T2DM patients.