Department of Internal Medicine, the Affiliated Hospital of Medical College, Qingdao University, Qingdao 266100, Shandong Province, China.
World J Gastroenterol. 2013 May 28;19(20):3134-42. doi: 10.3748/wjg.v19.i20.3134.
To evaluate the correlation between nonalcoholic fatty liver disease (NAFLD) and microvascular complications in type 2 diabetes mellitus (T2DM).
Data were obtained from 1217 inpatients with T2DM (757 females, 460 males; aged 63.39 ± 12.28 years). NAFLD was diagnosed by hepatic ultrasonography. Diabetic nephropathy (DN), diabetic peripheral neuropathy (DPN), and diabetic retinopathy (DR) were diagnosed according to their respective criteria. The prevalence of NAFLD and the independent correlations of clinical characteristics with NAFLD were determined by cross-tabulation and logistic regression, respectively.
Approximately 61% of inpatients with T2DM in Qingdao, China had NAFLD, which decreased significantly with increase in age and prolonged course of diabetes. The prevalence of NAFLD in patients presenting with DN, DPN and DR was 49.4%, 57.2% and 54.9%, respectively. These rates were significantly lower than those of patients without DN, DPN and DR (65.9%, 65.6% and 66.1%, respectively, P < 0.05). Participants with NAFLD had greater body weight, waist circumference (WC), body mass index (BMI), fasting blood glucose (FBG), hemoglobin A1c, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, blood pressure, as well as triglyceride (TG) levels and lower high-density lipoprotein (HDL) concentration than those without NAFLD (P < 0.05). NAFLD was positively correlated with BMI, WC, TG, FBG, diastolic blood pressure, and systolic blood pressure but negatively correlated with the duration of diabetes, DR, DPN, DN, and HDL.
Despite the benign nature of NAFLD, efforts should be directed toward early diagnosis, intensive blood glucose and blood pressure control, and effective dyslipidemia correction.
评估非酒精性脂肪性肝病(NAFLD)与 2 型糖尿病(T2DM)微血管并发症的相关性。
数据来自 1217 例 T2DM 住院患者(757 名女性,460 名男性;年龄 63.39±12.28 岁)。NAFLD 通过肝脏超声诊断。根据各自的标准诊断糖尿病肾病(DN)、糖尿病周围神经病变(DPN)和糖尿病视网膜病变(DR)。通过交叉表和逻辑回归分别确定 NAFLD 的患病率和临床特征与 NAFLD 的独立相关性。
中国青岛的 T2DM 住院患者中约有 61%患有 NAFLD,NAFLD 的患病率随着年龄的增长和糖尿病病程的延长而显著降低。患有 DN、DPN 和 DR 的患者中 NAFLD 的患病率分别为 49.4%、57.2%和 54.9%,显著低于未患有 DN、DPN 和 DR 的患者(分别为 65.9%、65.6%和 66.1%,P<0.05)。患有 NAFLD 的患者体重、腰围(WC)、体重指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、血压以及甘油三酯(TG)水平较高,而高密度脂蛋白(HDL)浓度较低(P<0.05)。NAFLD 与 BMI、WC、TG、FBG、舒张压和收缩压呈正相关,与糖尿病病程、DR、DPN、DN 和 HDL 呈负相关。
尽管 NAFLD 性质良性,但仍应努力实现早期诊断、强化血糖和血压控制以及有效的血脂异常纠正。