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【摘要】 目的：探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并非酒精性脂肪肝( non alcoholic fatty liver disease,NAFLD)的临床相关因素。方法：对新疆医科大学第五附属医院2008年1～6月的269例糖尿病住院患者进行回顾性分析,根据腹部B超结果分为合并NAFLD组148例,不合并NAFLD组121例。结果：与不合并NAFLD组比较，合并NAFLD的T2DM患者的体重指数(BMI)、腰围、血甘油三酯(TG)、低密度脂蛋白(LDLC)、舒张压(DSP)显著增高(P均<0.05)：同时高密度脂蛋白(HDLC)显著降低(P<0.05);Logistic回归分析显示：BMI、DBP、TG、LDLC、HDLC对T2DM合并的NAFLD的发生有显著影响(P均<0.05)。结论：2型糖尿病患者合并非酒精性脂肪肝，与肥胖(主要是腹型肥胖)、血脂紊乱、血压增高相关;而与糖尿病病程、血糖控制程度、糖尿病并发症不相关，导致糖尿病合并非酒精性脂肪肝的最主要原因为胰岛素抵抗及其所包含的脂代谢紊乱。
【关键词】 2型糖尿病 非酒精性脂肪肝 相关因素
A clinical study of relative factors in type 2 diabetes complicated with non alcoholic fatty liver disease
LI Xufang, Yiliduosi·Aihetamofu, GAO Jing医.学全.在.线网站www.lindalemus.com
(Department of Endocrinology, First Affiliated Hospital, Xinjiang Medical University,Urumqi 830011, China)
Abstract: Objective: To analyze the clinical relative factors in type 2 diabetes mellitus (T2DM) complicated with non alcoholic fatty liver disease. Methods: A total of 269 type 2 diabetes were selected in the Department of Endorcrinoloy, Five Affiliated Hospital, Xijiang Medical University, from January 2008 to June 2008.According to the color Bultrasonography detection of liver and gall, these subjects were divided into fatty liver group (n=148) and without fatty liver group (n=121). Results: Compared with the T2DM patients without NAFLD, the figures of BMI, waistline (WL), serum TG levels, serum LDLC levels and diastolic blood pressure increased significantly in the T2DM patients with NAFLD (P<0.05), while the serum HDLC levels decreased significantly (P<0.05);Logistic regression analysis suggested that BMI, WL, DSP, TG, LDLC, HDLC were significantly effected of the forming of T2DM with NAFLD (P<0.05). Conclusion: Obesity(ventrotype obesity), dyslipidosis, blood pressure increased were remarkably correlated with T2DM with NAFLD; and course of diabetes disease, the degree of blood glucose control were not correlated with T2DM with NAFLD， insulin resistance and it cause of dyslipidosis are main reason of T2DM with NAFLD.
Key words: type 2 diabetes mellitus; non alcoholic fatty liver disease; clinical relative factors
随着人们生活水平的提高、生活方式的改变，2型糖尿病(T2DM)合并非酒精性脂肪肝(non alcoholic fatty liver disease,NAFLD)在临床上呈升高趋势。非酒精性脂肪肝进一步可以发展为肝炎、肝纤维化以及肝硬化[1]。因此，我们分析糖尿病合并NAFLD与不合并NAFLD患者的一些临床指标，明确其相关因素，为防治糖尿病合并非酒精性脂肪肝提供依据。
