Yi M, Chen R-P, Yang R, Chen H
Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China.
Diabet Med. 2017 Apr;34(4):505-513. doi: 10.1111/dme.13174. Epub 2016 Sep 15.
To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes mellitus.
We recruited patients with Type 2 diabetes with a BMI ≥ 24 kg/m , who visited the diabetes clinics of 60 hospitals in 21 cities in Guangdong Province, China from August 2011 to March 2012. Anthropometric measurements, biochemical tests and abdominal ultrasonography were performed for all the patients.
The study included 3861 patients (1860 men) with a mean ± sd (range) age of 58.91 ± 13.06 (18-90) years. Non-alcoholic fatty liver disease was found in 1751 patients (45.4%), with a significantly higher prevalence among men than women (48.0 vs 42.9%). The peak of non-alcoholic fatty liver disease prevalence was in patients with a BMI of 34-35 kg/m , those with a triglyceride/HDL cholesterol ratio of 5.5-6.0, men aged < 30 years and women aged 40-50 years. Assessment using the BARD (BMI, aspartate aminotransferase/alanine aminotransferase ratio, diabetes) score system showed that the prevalence of advanced fibrosis was 80.52% in all patients and that women had a higher prevalence than men (86.52 vs 74.16%). Multiple logistic regression analyses showed that dyslipidaemia, BMI and 2-h postprandial plasma glucose were independent risk factors for non-alcoholic fatty liver disease, while heart rate and female gender were protective factors.
The prevalence of non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes in South China is high. Multiple metabolic disorders were significantly associated with non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes.
调查超重和肥胖的2型糖尿病患者中非酒精性脂肪性肝病的患病率及危险因素。
我们招募了2011年8月至2012年3月期间在中国广东省21个城市的60家医院糖尿病门诊就诊、BMI≥24 kg/m²的2型糖尿病患者。对所有患者进行人体测量、生化检测和腹部超声检查。
该研究纳入了3861例患者（1860例男性），平均年龄±标准差（范围）为58.91±13.06（18 - 90）岁。1751例患者（45.4%）被诊断为非酒精性脂肪性肝病，男性患病率显著高于女性（48.0%对42.9%）。非酒精性脂肪性肝病患病率的高峰出现在BMI为34 - 35 kg/m²、甘油三酯/高密度脂蛋白胆固醇比值为5.5 - 6.0、年龄<30岁的男性以及40 - 50岁的女性患者中。使用BARD（BMI、天冬氨酸转氨酶/丙氨酸转氨酶比值、糖尿病）评分系统评估显示，所有患者中晚期纤维化的患病率为80.52%，女性患病率高于男性（86.52%对74.16%）。多因素逻辑回归分析显示，血脂异常、BMI和餐后2小时血糖是非酒精性脂肪性肝病的独立危险因素，而心率和女性性别是保护因素。
中国南方超重和肥胖的2型糖尿病患者中非酒精性脂肪性肝病的患病率较高。多种代谢紊乱与超重和肥胖的2型糖尿病患者的非酒精性脂肪性肝病显著相关。
