Luo Yu, Wang Cuiyu, Zhang Tian, He Xiaoyu, Hao Jianan, Shen Andong, Zhao Hang, Chen Shuchun, Ren Luping
Endocrinology Department, Hebei General Hospital, Shijiazhuang, People's Republic of China.
Graduate School, Hebei North University, Zhangjiakou, People's Republic of China.
Int J Gen Med. 2023 Jan 24;16:293-302. doi: 10.2147/IJGM.S395948. eCollection 2023.
Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are frequently co-occurring diseases. Liver fibrosis (LF), with increasing incidence, has a prognostic value for NAFLD mortality. Our study aimed to investigate the relevant factors for FL in T2DM individuals with NAFLD.
A total of 565 T2DM patients with NAFLD from Hebei General Hospital participated in the study. Patients underwent an abdominal ultrasound, a questionnaire and laboratory tests. The fibrosis-4 index (FIB-4) was used to evaluate LF, with FIB ≥1.3 indicating LF and FIB ≥2.67 indicating F3-4 fibrosis.
Compared with NLF group, LF group had higher levels of systolic blood pressure (SBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transpeptidase (GGT). The glomerular filtration rate (GFR), low-density lipoprotein cholesterol (LDL), glycated hemoglobin (HbA1c), and platelets (PLT) in LF patients were lower than those without LF. Patients with LF were older than those without LF. ALT, AST, and GGT in patients with severe LF were higher than those with mild LF, while platelet was lower. Age, SBP, duration of diabetes, ALT, AST, and GGT were positively correlated with FIB-4, while eGFR, TC, LDL, and HbA1c were negatively correlated with FIB-4. Logistic regression showed that age, SBP, ALT, GGT, LDL, and PLT were independently associated with LF.
For T2DM patients combined with NAFLD, older age, higher SBP, higher ALT, higher GGT, lower LDL, and lower PLT were relevant factors for LF.
非酒精性脂肪性肝病(NAFLD)和2型糖尿病(T2DM)是常见的共患疾病。肝纤维化(LF)发病率不断上升,对NAFLD死亡率具有预后价值。我们的研究旨在调查T2DM合并NAFLD患者发生肝纤维化的相关因素。
河北医科大学第一医院的565例T2DM合并NAFLD患者参与了本研究。患者接受了腹部超声、问卷调查和实验室检查。采用纤维化-4指数(FIB-4)评估肝纤维化,FIB≥1.3表示存在肝纤维化,FIB≥2.67表示F3-4级纤维化。
与无肝纤维化组相比,肝纤维化组的收缩压(SBP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和γ-谷氨酰转肽酶(GGT)水平更高。肝纤维化患者的肾小球滤过率(GFR)、低密度脂蛋白胆固醇(LDL)、糖化血红蛋白(HbA1c)和血小板(PLT)低于无肝纤维化患者。肝纤维化患者的年龄大于无肝纤维化患者。重度肝纤维化患者的ALT、AST和GGT高于轻度肝纤维化患者,而血小板较低。年龄、SBP、糖尿病病程、ALT、AST和GGT与FIB-4呈正相关,而估算肾小球滤过率(eGFR)、总胆固醇(TC)、LDL和HbA1c与FIB-4呈负相关。Logistic回归显示,年龄、SBP、ALT、GGT、LDL和PLT与肝纤维化独立相关。
对于T2DM合并NAFLD患者,年龄较大、SBP较高、ALT较高、GGT较高、LDL较低和PLT较低是肝纤维化的相关因素。