T2DM并发非酒精性脂肪肝老年患者和动脉粥样硬化的关系及其相关影响因素研究

发布时间：2019-01-30 15:00

【摘要】：目的研究2型糖尿病(T2DM)并发非酒精性脂肪肝(NAFLD)老年患者和动脉粥样硬化的关系与相关影响因素。方法选择2010年4月至2013年4月在该院接受治疗的300例新诊断T2DM患者作为研究对象,T2DM并发NAFLD者150例(观察组),及未并发NAFLD者150例(对照组)。对比两组动脉内中膜厚度(IMT)超声检测结果,两组其他相关指标对比。分析颈总动脉IMT、股动脉IMT及足背动脉IMT与各指标的相关性,分析影响患者形成动脉粥样硬化及NAFLD的因素。结果观察组的颈总动脉IMT、股动脉IMT及足背动脉IMT均显著大于对照组的水平,差异均有统计学意义(P0.05)。观察组的BMI、腰臀比、餐后2h血浆葡萄糖(2hPS)、空腹胰岛素(FINS)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、糖化血红蛋白(HbAlc)、血尿酸(UA)及尿微量清蛋白(UAER)等指标水平均显著高于对照组,差异均有统计学意义(均P0.05)。Pearson相关分析显示,各动脉IMT与BMI、FINS、TG及LDL-C均呈正相关。根据Logistic回归分析法可知,FINS、TG及BMI是T2DM患者形成动脉粥样硬化的危险因素较未并发NAFLD者,而腰臀比、FINS、TG及BMI是T2DM患者形成NAFLD的危险因素。结论 T2DM并发NAFLD患者形成动脉粥样硬化的比例较未并发NAFLD者更高,且影响NAFLD的因素是腰臀比、FINS、TG及BMI等。在临床防治方面,值得对其加以关注。
[Abstract]:Objective to study the relationship between type 2 diabetes mellitus (T2DM) and atherosclerosis in elderly patients with non alcoholic fatty liver (NAFLD). Methods from April 2010 to April 2013, 300 newly diagnosed T2DM patients received treatment in our hospital. 150 patients with T2DM complicated with NAFLD (observation group) and 150 patients without NAFLD (control group) were studied. The results of (IMT) were compared between the two groups. To analyze the correlation between IMT of femoral artery and IMT of dorsalis pedis artery of common carotid artery (IMT,) and the factors influencing atherosclerosis and NAFLD in patients. Results IMT of common carotid artery IMT, and IMT of dorsalis pedis artery in observation group were significantly higher than those in control group (P0.05). BMI, waist-to-hip ratio, plasma glucose (2hPS), fasting insulin, (FINS), triglyceride (TG), high density lipoprotein (HDL-C), glycosylated hemoglobin (HbAlc), The levels of serum uric acid (UA) and urinary microalbumin (UAER) were significantly higher than those of the control group (P0.05). Pearson correlation analysis showed that IMT was positively correlated with BMI,FINS,TG and LDL-C). According to Logistic regression analysis, FINS,TG and BMI were the risk factors of atherosclerosis in T2DM patients compared with those without NAFLD, while WHR, FINS,TG and BMI were the risk factors for NAFLD in T2DM patients. Conclusion the incidence of atherosclerosis in patients with T2DM complicated with NAFLD is higher than that in patients without NAFLD, and the factors affecting NAFLD are waist hip ratio, FINS,TG and BMI, etc. In the aspect of clinical prevention and treatment, it is worth paying attention to.
【作者单位】：河北北方学院附属第一医院超声医学科;
【基金】：张家口市科学技术研究与发展计划项目(1321127D)
【分类号】：R575.5;R543.5;R445.1

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