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目的了解2型糖尿病(T2DM)患者非酒精性脂肪性肝病(NAFLD)与性激素水平的关系。方法选取2010年3月—2013年10月在绍兴市中心医院内分泌科住院的T2DM患者256例,根据是否合并NAFLD分为NAFLD组和非NAFLD组,比较两组患者性激素和糖脂代谢指标水平差异,采用多因素Logistic回归模型分析T2DM患者NAFLD患病的影响因素。结果 256例T2DM患者的NAFLD检出率为56.25%,男性检出率为59.15%,女性为52.63%,差异无统计学意义(P>0.05)。男性患者中,NAFLD组睾酮(T)水平为(3.78±1.13)ng/m L,低于非NAFLD组的(4.61±1.55)ng/m L(P<0.05);NAFLD组雌二醇(E2)水平为(22.24±12.88)pg/m L,高于非NAFLD组的(17.84±8.72)pg/m L(P<0.05)。女性患者中,NAFLD组E2水平为(19.83±8.61)pg/m L,低于非NAFLD组的(26.32±16.85)pg/m L(P<0.05)。多因素Logistic回归分析结果显示,T(OR=0.660,95%CI:0.495~0.880)和E2(OR=0.958,95%CI:0.922~0.996)水平分别是男、女性T2DM患者患NAFLD的保护因素,而E2(OR=1.042,95%CI:1.001~1.085)水平是男性T2DM患者患NAFLD的危险因素。结论 T2DM合并NAFLD患者存在性激素紊乱;T和E2分别是男、女T2DM患者患NAFLD的保护因素。
Objective To investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and sex hormone levels in type 2 diabetes mellitus (T2DM). Methods From March 2010 to October 2013, 256 patients with T2DM admitted to Department of Endocrinology, Shaoxing Central Hospital were divided into NAFLD group and non-NAFLD group according to NAFLD. The difference in sex hormone and glucose and lipid metabolism between the two groups was compared , Using multivariate Logistic regression model to analyze the influencing factors of NAFLD prevalence in T2DM patients. Results The detection rate of NAFLD in 256 T2DM patients was 56.25%. The male detection rate was 59.15% and the female was 52.63%. There was no significant difference (P> 0.05). In male patients, the level of testosterone in NAFLD group was (3.78 ± 1.13) ng / m L, lower than that in non-NAFLD group (4.61 ± 1.55 ng / m L) (P <0.05) ) Level was (22.24 ± 12.88) pg / m L, higher than that of non-NAFLD group (17.84 ± 8.72) pg / m L (P <0.05). In female patients, E2 level in NAFLD group was (19.83 ± 8.61) pg / m L, which was lower than that in non-NAFLD group (26.32 ± 16.85) pg / m L (P <0.05). Multivariate Logistic regression analysis showed that the levels of T (OR = 0.660, 95% CI: 0.495-0.880) and E2 (OR = 0.958, 95% CI: 0.922-0.996) were the protective factors for NAFLD in both male and female T2DM patients , While E2 (OR = 1.042, 95% CI: 1.001 ~ 1.085) was a risk factor for NAFLD in male patients with T2DM. Conclusions There are sex hormone disorders in T2DM patients with NAFLD. T and E2 are protective factors for NAFLD in both male and female T2DM patients.