Kim Hai Jin, Cho Min Ho, Park Jong Suk, Nam Ji Sun, Kang Eun Seok, Ahn Chul Woo, Cha Bong Soo, Lee Eun Jig, Lim Sung Kil, Kim Kyung Rae, Lee Hyun Chul, Huh Kap Bum
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Yongdong Severance Hospital, 146-92 Dogok-dong, Gangnam-gu, Seoul, Korea.
J Korean Med Sci. 2008 Apr;23(2):256-61. doi: 10.3346/jkms.2008.23.2.256.
Our aim was to study whether visceral adiposity is a predictor of diabetic fatty liver in Korean type 2 diabetes mellitus. In this study, abdominal ultrasonography was used to assess the presence of fatty liver in 1,898 patients with type 2 diabetes. We measured visceral fat thickness by high-resolutional ultrasonography and insulin resistance by Kitt. Half of the cohort had a fatty liver (50.2%). High visceral fat thickness had the highest odds ratio for developing fatty liver in both sexes (odds ratio [S.D]: 3.14 [2.24-4.69], p<0.00 in male, 2.84 [2.04-3.93], p<0.00 in female). In addition, visceral fat thickness of 42.45 and 37.7 mm in men and women, respectively, were chosen as the discriminating value to predict the presence of fatty liver with a sensitivity of 71% and 73% and a specificity of 70% and 70% in men and women, respectively. The area under the receiver-operating characteristics curve was 0.759 in men and 0.764 in women. Therefore we could conclude that the degree of visceral adiposity predicts the presence of fatty liver type 2 diabetes mellitus, whether centrally obese or not, suggesting that hepatic fat accumulation in a diabetic fatty liver may be influenced by visceral fat accumulation regardless of waist circumference.
我们的目的是研究内脏脂肪过多是否是韩国2型糖尿病患者发生糖尿病性脂肪肝的一个预测指标。在本研究中,采用腹部超声检查评估1898例2型糖尿病患者是否存在脂肪肝。我们通过高分辨率超声测量内脏脂肪厚度,并通过基特法测量胰岛素抵抗。该队列中有一半患者患有脂肪肝(50.2%)。高内脏脂肪厚度在男女两性中发生脂肪肝的比值比最高(比值比[标准差]:男性为3.14[2.24 - 4.69],p < 0.00;女性为2.84[2.04 - 3.93],p < 0.00)。此外,男性和女性的内脏脂肪厚度分别以42.45和37.7 mm作为判别值,用于预测脂肪肝的存在,男性和女性的敏感性分别为71%和73%,特异性分别为70%和70%。男性受试者工作特征曲线下面积为0.759,女性为0.764。因此我们可以得出结论,无论是否为中心性肥胖,内脏脂肪过多的程度均可预测2型糖尿病患者是否存在脂肪肝,这表明糖尿病性脂肪肝中的肝脏脂肪堆积可能受内脏脂肪堆积的影响,而与腰围无关。