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目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的相关因素,为防治T2DM合并NAFLD的发病提供依据。方法选取2013年1月至2014年12月在北京市丰台区铁营医院内科收治的247例T2DM患者为研究对象,男性126例,女性121例,年龄30~87岁,平均(52.0±8.1)岁,病程1~30年。以是否合并NAFLD分为T2DM合并NAFLD组(166例)和T2DM组(81例)。分别测量两组患者身高、体重、腰围(WC)、臀围、收缩压和舒张压,并计算体质指数(BMI)、腰臀比(WHR),测定空腹血糖、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(Hb A1C)、空腹C肽(FCP)、空腹胰岛素(FINS)和肝功能等。结果 T2DM合并NAFLD组BMI、WC、TG、SBP、FINS和FCP水平显著高于T2DM组,差异均有统计学意义(P<0.05,P<0.01)。多因素非条件logistic回归分析结果显示,BMI、FCP和WC是T2DM并发NAFLD的影响因素。结论应重视体重控制并改善胰岛素抵抗,防治T2DM合并NAFLD的发病。
Objective To investigate the related factors of type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) and provide basis for the prevention and treatment of T2DM complicated with NAFLD. Methods A total of 247 T2DM patients admitted to Tieying Hospital, Fengtai District, Beijing from January 2013 to December 2014 were enrolled in this study. There were 126 males and 121 females aged from 30 to 87 years (mean, 52.0 ± 8.1) Years old, duration of 1 to 30 years. The patients with NAFLD were divided into T2DM combined NAFLD group (166 cases) and T2DM group (81 cases). Body height, body weight, waist circumference (WC), hip circumference, systolic pressure and diastolic blood pressure were measured. Body mass index (BMI) and WHR were measured. Fasting blood glucose, total cholesterol (TC), triglyceride (TG), LDL-C, HDL-C, Hb A1C, FCP, FINS and liver function, etc. . Results The levels of BMI, WC, TG, SBP, FINS and FCP in T2DM with NAFLD were significantly higher than those in T2DM (P <0.05, P <0.01). Multivariate non-conditional logistic regression analysis showed that BMI, FCP and WC were the influencing factors of T2DM complicated with NAFLD. Conclusion We should pay attention to weight control and improve insulin resistance, prevention and treatment of T2DM with NAFLD incidence.