[1]张 敏,陈 璐,瞿美娣,等.2型糖尿病病人合并非酒精性脂肪性肝病的危险因素分析[J].肠外与肠内营养杂志,2019,(05):271-275.[doi:DOI : 10.16151/j.1007-810x.2019.05.004]
 ZHANG Min,CHEN Lu,Q? Mei-di,et al.Analysis of the risk factors for NAFLD in patients with T2DM[J].PARENTERAL & ENTERAL NUTRITION,2019,(05):271-275.[doi:DOI : 10.16151/j.1007-810x.2019.05.004]
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2型糖尿病病人合并非酒精性脂肪性肝病的危险因素分析
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2019年05期
页码:
271-275
栏目:
论著
出版日期:
2019-09-10

文章信息/Info

Title:
Analysis of the risk factors for NAFLD in patients with T2DM
作者:
张 敏陈 璐瞿美娣顾红柳沙 琦仇 怡华 飞
江苏省常州市第一人民医院临床营养科,江苏常州213003
Author(s):
ZHANG Min CHEN Lu Q? Mei-di GU Hong-liu SHA Qi QIU Yi HUA Fei
Department of Clinic Nutrition, The First People's Hospital of Changzhou, Changzhou 213003,Jiangsu, China
关键词:
非酒精性脂肪性肝病 2型糖尿病 空腹 C肽水平 人体体成分分析 相位角
Keywords:
Nonalcoholic Fatty Liver Disease Type 2 Diabetes Mellitus Fasting C-peptide Body composition analysis Phase angle
分类号:
R448
DOI:
DOI : 10.16151/j.1007-810x.2019.05.004
文献标志码:
A
摘要:
目的:通过人体体成分分析、人体测量、胰岛功能检测及生化检查等多项综合营养评价手段对 2型糖尿病(T2DM)病人合并非酒精性脂肪性肝病(NAFLD)的危险因素进行分析。 方法:分析 2017年 1月至 2018年10月江苏省常州市第一人民医院临床营养科进行营养评估的 T2DM住院病人临床资料,按照有无合并 NAFLD分为病例组(n = 210)和对照组(n = 157),同时进行年龄与身体质量指数(BMI)匹配,观察两组病人人体体成分分析、人体测量、胰岛功能检查及血生化指标。 结果:经过年龄与 BMI匹配的两组病人进行对比,T2DM合并 NAFLD病人的空腹 C肽、胰岛功能指数(Homa-IR)、胰岛素抵抗指数(Homa-islet)、血尿酸、ALT、AST、总胆红素、总蛋白水平及血白蛋白水平均显著增高(P < 0.05)。在 T2DM病人空腹 C肽、相位角均是合并 NAFLD的危险因素。而对男女病人中分别进行 logistics回归:空腹 C肽、总蛋白、相位角是男性 T2DM病人合并 NAFLD的危险因素;而空腹 C肽及餐后 2小时血糖(2hPG)则是女性 T2DM病人合并 NAFLD的危险因素。 结论:在 T2DM病人中,空腹 C肽的升高是 T2DM病人合并 NAFLD的危险因素。与女性 T2DM病人相比,人体体成分分析对于男性 T2DM病人合并NAFLD的诊断以及监测意义可能更为重要。
Abstract:
Objective: The risk factors of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients were analyzed by the comprehensive nutritional assessments, including body composition analysis,anthropometry, islet function monitoring and blood biochemical examination. Methods: A total of 360 patients with T2DM were enrolled in the Clinical Nutrition Department of Changzhou First People's Hospital, between January 2017 and October 2018. The patients were divided into two groups: NAFLD group(n = 210)and control group (n = 150) , according to the presence or absence of NAFLD. The body composition, anthropometry, islet function and blood biochemical indicators of the patients in both groups were examined. The multivariable logistic regression analysis was used to evaluate risk factors of NAFLD in the patients. Results: Fasting C-peptide, islet function index (Homa-IR), insulin resistance index (Homa-islet), and the serum levels of uric acid, ALT, AST, total bilirubin, total protein and albumin were markedly elevated in NAFLD group, comparing with those of the controls. Also, the level of serum albumin was significantly increased in NAFLD group. The logistic regression analysis showed that the risk factors of NAFLD in T2DM patients were fasting C-peptide and phase angle. In the male patients with T2DM, the risk factors of NAFLD included fasting C-peptide, totalprotein, and phase angle, and in the female patients, the risk factors were fasting C-peptide and 2-hour postprandial blood glucose levels. Conclusion: In patients with T2DM, elevated fasting C-peptide is a risk factor for NAFLD in patients with T2DM, both male and female. In male T2DM patients, body composition analysis may be more important for the diagnosis and monitoring of NAFLD.

参考文献/References:


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备注/Memo

备注/Memo:
基金项目 :常州市卫计委重大科技项目(ZD201512) 作者简介 :张 敏,主治医师,医学硕士,从事临床营养专业。E-mail:kaba-314@163.com 通讯作者 :华 飞,E-mail:feihua_czyy@126.com
更新日期/Last Update: 1900-01-01