目的 探讨湿热困脾型2型糖尿病合并非酒精性脂肪性肝病的主要危险因素.方法 收集2018年6月-2020年6月我院收治的300例湿热困脾型T2DM患者,是否存在NAFLD分为合并脂肪肝组与非脂肪肝组,比较2组患者体质量指数、外周血的谷草转氨酶(aspartate transaminase,AST)、谷丙转氨酶(alanine transaminase,ALT)、r-谷氨移转肽酶(gamma-glutamyl transferase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)、高密度脂蛋白(high-density lipoprotein cholesterol,HDL-C)、血尿酸(serum uric acid,SUA)、三酰甘油(triglyceride,TG)、低密度脂蛋白(low-density lipoprotein cholesterol,LDL-C)、总胆固醇(total cholesterol,TC)、空腹 C 肽(fasting C-peptide,FC-P)、空腹胰岛素(serum fasting insulin,FINS)、胰岛素抵抗(insulin resistance,IR)和空腹血糖(fasting blood glucose,FBG)的差异.结果 单因素分析显示,T2DM合并NAFLD患者体质量指数、IR、肝硬度、脾硬度、脾脏厚度、GGT、ALP、SUA、TG、TC、LDL-C、FBG 显著高于非脂肪肝组(均 P<0.05),HDL-C、FINS显著低于非脂肪肝组(P<0.05).多因素分析显示,BMI和IR是T2DM合并NAFLD患者的危险因素(P<0.05).结论 BMI和IR是湿热困脾型T2DM合并NAFLD患者的主要危险因素.
Objective To investigate the main risk factors for the syndrome of dampness-heat retaining in the spleen in type 2 diabetes mellitus(T2DM)patients complicated with nonalcoholic fatty liver disease(NAFLD).Methods From June 2018 to June 2020,300 T2DM patients with the syndrome of dampness-heat retaining in the spleen in our hospital were divided into a fatty liver group and a non-fatty liver group for the presence of NAFLD.The body mass index(BMI),aspartate transaminase(AST),alanine transaminase(ALT),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP),high-density lipoprotein cholesterol(HDL-C),serum uric acid(SUA),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),fasting C-peptide(FC-P),serum fasting insulin(FINS),insulin resistance(IR)and fasting blood glucose(FBG)were compared between the two groups.Results The single factor analysis showed that the levels of BMI,IR,liver hardness,spleen hardness,spleen thickness,GGT,ALP,SUA,TG,TC,LDL-C,FBG of T2DM complicated with NAFLD were significantly higher than those of the non-fatty liver group(all P<0.05),while the levels of HDL-C and FINS were significantly lower than those of the non-fatty liver group(P<0.05).The multivariate analysis showed that BMI and IR were the risk factors for T2DM patients with NAFLD(P<0.05).Conclusion BMI and IR are the main risk factors for the syndrome of dampness-heat retaining in the spleen in T2DM patients complicated with NAFLD.