论文部分内容阅读
目的探讨新确诊2型糖尿病(type 2 diabetes mellitus,T2DM)患者临床特点,并分析该患者群中非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)、高尿酸血症、颈围、颈动脉内中膜厚度(carotid intima-media thicknesCIMT)间的相关性。方法收集并分析85例病程1年以内、新确诊即住院治疗的T2DM患者的临床资料,包括颈围、腰围、腰臀比和体质指数,空腹胰岛素、空腹C-肽、糖化血红蛋白、肝肾功能、血脂分型及尿微量白蛋白水平,肝脏和颈动脉超声等。结果 85例患者中,合并NAFLD、高尿酸血症和CIMT增厚者分别占57.6%(49/85)、16.5%(14/85)和29.4%(25/85)。88.2%(75/85)的患者合并2种及以上代谢异常,T2DM合并NAFLD组、高尿酸血症组及颈围增大组代谢异常数量均多于其他无相应病变组(P<0.05);各组间体质指数、颈围、腰围,丙氨酸转氨酶、三酰甘油水平的差异均有统计学意义(P均<0.05)。多因素非条件logistic回归分析显示,颈围、腰围、体质指数、丙氨酸转氨酶、空腹C-肽及血尿酸是NAFLD及CIMT增厚的共同危险因素。结论 T2DM确诊时绝大多数患者已有多种代谢异常;NAFLD、高尿酸血症、颈围增大及CIMT增厚不仅互为危险因素,而且颈围和血尿酸水平等是NAFLD和CIMT增厚的共同危险因素。
Objective To investigate the clinical features of type 2 diabetes mellitus (T2DM) and analyze the association between NAFLD, hyperuricemia, neck circumference, carotid artery The correlation between carotid intima-media thicknes CIMT. Methods The clinical data of 85 patients with T2DM newly diagnosed and hospitalized within 1 year after the course of disease were collected and analyzed including neck circumference, waist circumference, waist-hip ratio, body mass index, fasting insulin, fasting C-peptide, glycosylated hemoglobin, , Lipid profile and urine microalbumin level, liver and carotid artery ultrasound. Results Among the 85 patients, 57.6% (49/85), 16.5% (14/85) and 29.4% (25/85) had NAFLD, hyperuricemia and CIMT thickening, respectively. In 88.2% (75/85) patients, there were more than two kinds of metabolic abnormalities. The number of metabolic abnormalities in T2DM complicated with NAFLD, hyperuricemia and neck enlargement were more than those without corresponding lesions (P <0.05). The difference of body mass index, neck circumference, waist circumference, alanine aminotransferase and triglyceride between the two groups were statistically significant (all P <0.05). Multivariate non-conditional logistic regression analysis showed that neck circumference, waist circumference, body mass index, alanine aminotransferase, fasting C-peptide and serum uric acid were common risk factors for NAFLD and CIMT thickening. Conclusions The vast majority of patients with T2DM diagnosis have a variety of metabolic abnormalities; NAFLD, hyperuricemia, increased neck circumference and CIMT thickening are not only risk factors for each other, but also the neck circumference and serum uric acid levels are NAFLD and CIMT thickening Common risk factors.