中老年2型糖尿病患者非酒精性脂肪性肝病的临床特征分析

Clinical Feathers of Nonalcoholic Fatty Liver Disease in middle-aged Patients with Type 2 Diabetes Mellitus

中文关键词: 中老年  2型糖尿病  非酒精性脂肪性肝病

英文关键词: middle-aged  type 2 diabetes mellitus  nonalcoholic fatty liver disease (NAFLD)

中文摘要:

      目的 了解中老年2型糖尿病患者非酒精性脂肪性肝病的构成比及相关临床特征,寻找其患病的危险因素.方法 选取2015年1月1日-2016年10月31日在复旦大学附属华东医院住院,年龄大于45岁的糖尿病患者497例,分为合并非酒精性脂肪性肝病组(NAFLD组)和不合并非酒精性脂肪性肝病组(非NAFLD组),调查高血压病和冠心病的患病率,检测各组患者的肝功能、血脂、尿微量蛋白、肌电图和血管B超等指标并进行组间比较,NAFLD与各种影响因素间相关性检验用Logistic多因素回归分析.结果 中老年2型糖尿病住院患者中NAFLD患病率为71.6％,2型糖尿病合并NAFLD患者的ALT、AST、ALP、GGT、TC、TG和血尿酸水平显著高于非NAFLD组.且其高血压病、视网膜病变和糖尿病肾病的患病率高于非NAFLD患者.女性、高三酰甘油血症和高血压病可分别使中老年2型糖尿病患者NAFLD患病风险增加2.71倍、2.16倍和1.55倍.HDL可以降低NAFLD的患病风险.结论 中老年2型糖尿病住院患者具有较高的NAFLD患病率,女性、高血压、高TG水平和低HDL水平是2型糖尿病患者NAFLD发病的高危因素.

英文摘要:

      Objective To investigate the prevalence and clinical features of nonalcoholic fatty liver disease (NAFLD) in middle-aged patients with type 2 diabetes mellitus so as to find out the risk factors of NAFLD.Methods 497 patients,aged over 45,hospitalized in Huadong Hospital affiliated to Fudan University during the period from Jan.,1,2015 to Oct.,31,2016 were selected and divided into 2 groups:NAFLD group (complicated with nonalcoholic fatty liver disease) and nonNAFLD group (complicated with no nonalcoholic fatty liver disease);the prevalence of hypertension and coronary heart disease were noted;detections of Alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP),glutamyl transpeptidase (GGT),fasting glucose,glycated hemoglobin,glycated albumin,uric acid,total cholesterol (TC),triglycerides (TG),low density lipoprotein (LDL),high density lipoprotein (HDL),urine microalbumin,the ratio of urine microalbumin and creatinine were made and electromyography,vascular ultrasound and fundus examination were conducted,the data of the patients in the 2 groups were compared and analyzed;Multiple Logistic Regression Analysis was applied in estimating the odds ratio for risk factors of NAFLD.Results The prevalence of NAFLD in middle-aged patients with type 2 diabetes mellitus was 71.6 ％;the levels of ALT,AST,ALP,GGT,TC,TG and uric acid in patients of NAFLD group were much higher than those in patients of non-NAFLD group as well as the prevalence of hypertension,retinopathy and diabetic nephropathy;female,high TG levels and hypertension increased the prevalence of NAFLD by 2.71 times,2.16 times and 1.55 times respectively while high density lipoprotein (HDL) decreased the occurrence risk of NAFLD.Conclusions The prevalence of NAFLD in middle-aged hospitalized patients with type 2 diabetes mellitus is high;female,hypertension,high TG levels and low levels of HDL are risk factors of NAFLD in type 2 diabetes mellitus patients.