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目的 分析2型糖尿病患者发生脂肪肝的独立危险因素。方法 2型糖尿病伴脂肪肝患者163例,2型糖尿病非脂肪肝患者63例怍为对照组。对两组的相关变量进行logistic回归分析,并比较两组临床和肝功能等指标。结果 2型糖尿病脂肪肝组,肥胖和高脂血症患者的比例明显高于对照组。体重指数优势比(OR)为4.392与2型糖尿病脂肪肝呈正相关,胰岛素敏感性指数OR为0.000、规则使用胰岛素治疗OR为0.058与2型糖尿病脂肪肝呈负相关。2型糖尿病脂肪肝组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、AST/ALT<1和γ-谷氨酰转移酶(GGT)的异常率分别为16.0％、25.2％、52.8％和31.9％,对照组分别为3.2％、6.4％、36.5％和11.1％,x~2值分别为6.833、10.075、4.807和10.181,P值均<0.05。结论 肥胖和胰岛素抵抗的2型糖尿病患者是脂肪肝的独立危险因素。2型糖尿病脂肪肝患者易发生血脂紊乱和肝功能损害。
Objective To analyze the independent risk factors of fatty liver in type 2 diabetic patients. Methods Sixty-three patients with type 2 diabetes with fatty liver and 63 patients with type 2 diabetes without fatty liver were selected as the control group. Logistic regression analysis was performed on the two groups of related variables, and the clinical and liver function indexes were compared between the two groups. Results Type 2 diabetic fatty liver group, obesity and hyperlipidemia patients was significantly higher than the control group. Body mass index odds ratio (OR) was 4.392 and type 2 diabetes was positively correlated with fatty liver, insulin sensitivity index OR was 0.000, regular use of insulin treatment for 0.058 and type 2 diabetes was negatively correlated with fatty liver. The abnormal rates of aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST / ALT <1 and γ-glutamyltransferase (GGT) in type 2 diabetic fatty liver group were 16.0% , 25.2%, 52.8% and 31.9% in the control group and 3.2%, 6.4%, 36.5% and 11.1% in the control group respectively. The values of x ~ 2 were 6.833, 10.075, 4.807 and 10.181, respectively. Conclusion Obesity and insulin resistance in type 2 diabetic patients are independent risk factors for fatty liver. Type 2 diabetic patients with fatty liver prone to dyslipidemia and liver dysfunction.