目的:本研究探讨2型糖尿病(T2DM)患者肝脏脂肪含量(LFC)与代谢特征的相关性及其与慢性并发症的关系。
方法:81例前瞻性纳入的T2DM患者,根据是否存在NAFL并发症分为非酒精性脂肪性肝病(NAFLD)组和非NAFLD组。通过MRIIDEAL-IQ序列确定LFC,根据LFC按四分位数法分为4组。基本信息,代谢指标,并对不同组慢性并发症的发生情况进行分析比较。
结果:BMI,SBP,DBP,TG,ALT,AST,GGT,UA,HbA1c,FCP,2hCP,HOMA-IR,NAFLD组的HOMA-IS明显高于非NAFLD组(P<0.05)。NAFLD组慢性并发症发生率高于非NAFLD组,但无统计学意义(P>0.05)。BMI,SBP,DBP,TC,TG,ALT,AST,FCP,2hCP,HOMA-IR,和HOMA-IS在不同LFC患者之间显示显着差异,这些指标在LFC较高的患者中显著高于LFC较低的患者(P<0.05)。此外,糖尿病持续时间,TC,HOMA-IR,和LFC是ASCVD并发症的危险因素,虽然糖尿病持续时间,TG,和LDL-C是DN并发症的危险因素。此外,糖尿病病程和SBP是T2DM患者发生DR和DPN并发症的危险因素(P<0.05)。
结论:LFC与T2DM患者的全身代谢紊乱和慢性并发症的严重程度呈正相关。
OBJECTIVE: This study investigated the correlation of liver fat content (LFC) with metabolic characteristics and its association with chronic complications in type 2 diabetes mellitus (T2DM) patients.
METHODS: Eighty-one prospectively enrolled T2DM patients were divided into non-alcoholic fatty liver disease (NAFLD) group and the non-NAFLD group according to the presence of NAFL complications. LFC was determined by MRI IDEAL-IQ Sequence, and patients were divided into 4 groups according to LFC by quartile method. Basic information, metabolic indexes, and occurrence of chronic complications in different groups were analyzed and compared.
RESULTS: BMI, SBP, DBP, TG, ALT, AST, GGT, UA, HbA1c, FCP, 2 h CP, HOMA-IR, and HOMA-IS in the NAFLD group were significantly higher than the non-NAFLD group (P < 0.05). The incidences of chronic complications in the NAFLD group were higher than in the non-NAFLD group but not statistically significant (P > 0.05). BMI, SBP, DBP, TC, TG, ALT, AST, FCP, 2 h CP, HOMA-IR, and HOMA-IS showed significant differences between the patients with different LFC, and these indexes were significantly higher in patients with higher LFC than those with lower LFC (P < 0.05). Moreover, diabetes duration, TC, HOMA-IR, and LFC were the risk factors for ASCVD complications, while diabetes duration, TG, and LDL-C were risk factors for DN complications. Also, diabetes duration and SBP were risk factors for both DR and DPN complications in T2DM patients (P < 0.05).
CONCLUSIONS: LFC is positively correlated with the severity of the systemic metabolic disorder and chronic complications in T2DM patients.