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2 型糖尿病患者肝脂肪含量与全身代谢及慢性并发症的关系。

Relationship of liver fat content with systemic metabolism and chronic complications in patients with type 2 diabetes mellitus.

机构信息

Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No.613, West Huangpu Avenue, Huizhou District, Guangzhou, 510630, China.

General Practice Department, South China Normal University Hospital. No.55, West of Zhongshan Avenue, Tianhe District, Guangzhou, 510632, China.

出版信息

Lipids Health Dis. 2023 Jan 24;22(1):11. doi: 10.1186/s12944-023-01775-6.

Abstract

OBJECTIVE

This study investigated the correlation of liver fat content (LFC) with metabolic characteristics and its association with chronic complications in type 2 diabetes mellitus (T2DM) patients.

METHODS

Eighty-one prospectively enrolled T2DM patients were divided into non-alcoholic fatty liver disease (NAFLD) group and the non-NAFLD group according to the presence of NAFL complications. LFC was determined by MRI IDEAL-IQ Sequence, and patients were divided into 4 groups according to LFC by quartile method. Basic information, metabolic indexes, and occurrence of chronic complications in different groups were analyzed and compared.

RESULTS

BMI, SBP, DBP, TG, ALT, AST, GGT, UA, HbA1c, FCP, 2 h CP, HOMA-IR, and HOMA-IS in the NAFLD group were significantly higher than the non-NAFLD group (P < 0.05). The incidences of chronic complications in the NAFLD group were higher than in the non-NAFLD group but not statistically significant (P > 0.05). BMI, SBP, DBP, TC, TG, ALT, AST, FCP, 2 h CP, HOMA-IR, and HOMA-IS showed significant differences between the patients with different LFC, and these indexes were significantly higher in patients with higher LFC than those with lower LFC (P < 0.05). Moreover, diabetes duration, TC, HOMA-IR, and LFC were the risk factors for ASCVD complications, while diabetes duration, TG, and LDL-C were risk factors for DN complications. Also, diabetes duration and SBP were risk factors for both DR and DPN complications in T2DM patients (P < 0.05).

CONCLUSION

LFC is positively correlated with the severity of the systemic metabolic disorder and chronic complications in T2DM patients.

摘要

目的

本研究旨在探讨肝脂肪含量(LFC)与代谢特征的相关性及其与 2 型糖尿病(T2DM)患者慢性并发症的关系。

方法

81 例前瞻性入组的 T2DM 患者根据是否存在 NAFL 并发症分为非酒精性脂肪性肝病(NAFLD)组和非-NAFLD 组。采用 MRI IDEAL-IQ 序列测定 LFC,根据 quartile 法将患者分为 4 组。分析并比较不同组的基本信息、代谢指标和慢性并发症的发生情况。

结果

NAFLD 组的 BMI、SBP、DBP、TG、ALT、AST、GGT、UA、HbA1c、FCP、2 h CP、HOMA-IR 和 HOMA-IS 均明显高于非-NAFLD 组(P<0.05)。NAFLD 组的慢性并发症发生率高于非-NAFLD 组,但无统计学意义(P>0.05)。不同 LFC 患者的 BMI、SBP、DBP、TC、TG、ALT、AST、FCP、2 h CP、HOMA-IR 和 HOMA-IS 均有显著差异,且 LFC 较高的患者高于 LFC 较低的患者(P<0.05)。此外,糖尿病病程、TC、HOMA-IR 和 LFC 是 ASCVD 并发症的危险因素,而糖尿病病程、TG 和 LDL-C 是 DN 并发症的危险因素。另外,糖尿病病程和 SBP 是 T2DM 患者 DR 和 DPN 并发症的危险因素(P<0.05)。

结论

LFC 与 T2DM 患者全身代谢紊乱的严重程度及慢性并发症呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cfb/9872378/c96d84d390a5/12944_2023_1775_Fig1_HTML.jpg

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