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目的比较维吾尔族和汉族2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者的代谢特征,探讨T2DM合并NAFLD的相关危险因素。方法以在新疆乌鲁木齐市六道湾职工医院进行体检的神新集团在职及离退休人员为研究对象(2664例),分析其体检结果和血生化检测结果。结果2664例体检者中,汉族人1696例,维吾尔族人886例,其他民族人82例。体检发现T2DM患者265例,T2DM合并NAFLD患者(DFL组)117例,T2DM不伴NAFLD患者(NDFL组)148例。汉族和维吾尔族T2DM患者中NAFLD检出率分别为37.0%(60/162)和55.1%(54/98)。DFL组患者的腰围,体质指数,舒张压,三酰甘油、空腹胰岛素、血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平,胰岛素抵抗指数(HOMA-IR)与NDFL组比较,差异均有统计学意义(P<0.05)。DFL组中维吾尔族患者的腰围、体质指数、Fins与汉族患者比较,差异均有统计学意义(P<0.05)。NDFL组中维吾尔族患者的腰围、收缩压与汉族患者比较,差异亦有统计学意义(P<0.05)。多因素Logistic逐步回归分析显示,腰围和HOMA-IR对NAFLD的发生有显著影响〔P<0.01,OR值分别为1.190和5.389,95%CI分别为(1.079,1.312)和(1.580,18.387)〕。结论T2DM合并NAFLD患者存在明显的超重、中心性肥胖、血脂紊乱及胰岛素抵抗,且腰围与胰岛素抵抗是NAFLD发病的危险因素。维吾尔族T2DM合并NAFLD患者比汉族患者具有更明显的中心性肥胖和胰岛素抵抗。
Objective To compare the metabolic characteristics of Uygur and Han patients with type 2 diabetes mellitus (T2DM) with non-alcoholic fatty liver disease (NAFLD) and explore the related risk factors of T2DM with NAFLD. Methods A total of 2 644 active and retired staff of Shenxin Group, who performed physical examination at Liuduowan Workers’ Hospital in Urumqi, Xinjiang, were analyzed for their physical examination results and blood biochemical test results. Results Among the 2664 cases, 1696 were Han, 886 were Uyghurs and 82 were other ethnic groups. A total of 265 T2DM patients, 117 T2DM patients with NAFLD (DFL group) and 148 patients with T2DM without NAFLD (NDFL group) were found on physical examination. The detection rates of NAFLD in Han and Uygur T2DM patients were 37.0% (60/162) and 55.1% (54/98) respectively. Body mass index, diastolic blood pressure, triglyceride, fasting insulin, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and insulin resistance index (HOMA-IR) Compared with NDFL group, the differences were statistically significant (P <0.05). In the DFL group, waist circumference, body mass index and Fins in Uighur patients were significantly different from those in Han patients (P <0.05). The waist circumference and systolic blood pressure of Uygur patients in NDFL group were also significantly different from those in Han patients (P <0.05). Multivariate Logistic stepwise regression analysis showed that waist circumference and HOMA-IR had significant effects on the incidence of NAFLD (P <0.01, OR = 1.190 and 5.389, respectively, with 95% CI being 1.079, 1.312 and 1.580, 18.387 respectively) . Conclusion T2DM with NAFLD patients have significant overweight, central obesity, dyslipidemia and insulin resistance, and waist circumference and insulin resistance are risk factors for the pathogenesis of NAFLD. Uighur T2DM patients with NAFLD have more obvious central obesity and insulin resistance than Han patients.