摘要目的:分析2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的临床特点及影响因素。方法:按入院顺序抽取2019年1月至2022年1月在郑州颐和医院内分泌科住院诊疗的100例未合并NAFLD的T2DM患者(DM组)及100例合并NAFLD的T2DM患者(DM合并NAFLD组)，比较两组性别、年龄、糖尿病病程、体质指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL－C)、低密度脂蛋白胆固醇(LDL－C)等指标；两组均行口服葡萄糖耐量试验(OGTT)、C肽释放试验(CP 0 min、CP 30 min、CP 60 min、CP120 min、CP 180 min)，计算胰岛β细胞功能指数(HOMA－β)、胰岛素抵抗指数(HOMA－IR)、C肽曲线下面积(AUCC)。分析T2DM合并NAFLD与胰岛功能的关系及影响因素。结果:DM合并NAFLD组BMI、FPG、HbA1c、TC、TG、AUCC、HOMA－IR CP、HOMA－IR INS均高于DM组( P均<0.05)，年龄、糖尿病病程、HDL－C小于DM组( P<0.05)，两组LDL－C、HOMA－β CP、HOMA－β INS比较差异未见统计学意义( P>0.05)。以是否合并NAFLD为因变量，其他指标为自变量行二元Logistic回归分析结果显示，BMI( OR＝1.56， P<0.001)、TG( OR＝3.29， P＝0.001)、LDL－C( OR＝4.11， P＝0.021)是T2DM合并NAFLD的危险因素。 结论:血糖控制不佳、血脂水平高、体质指数高、胰岛素抵抗的T2DM患者更易合并NAFLD。

abstractsObjective:To analyze the clinical characteristics and influencing factors of type 2 diabetes mellitus (T2DM) complicated by non-alcoholic fatty liver disease (NAFLD).Methods:One hundred T2DM patients without NAFLD (DM group) and 100 T2DM patients with NAFLD (DM combined with NAFLD group) who were hospitalized in the Department of Endocrinology of Zhengzhou Yihe Hospital from January 2019 to January 2022 were selected according to the admission order; the gender, age, course of diabetes, body mass index (BMI), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) were compared between the two groups. Both groups underwent oral glucose tolerance test (OGTT), C-peptide release test (CP 0 min, CP 30 min, CP 60 min, CP120 min, CP 180 min); homeostasis model assessment of β cell function (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR), area under C-peptide curve (AUCC) of the two groups were counted. The relationship of T2DM complicated by NAFLD with islet function and its influencing factors were analyzed.Results:BMI, FPG, HbA1c, TC, TG, AUCC, HOMA-IR CP, HOMA-IR INS in the DM combined with NAFLD group were higher than those in the DM group (all P<0.05), age, duration of diabetes and HDL-C were lower than those in the DM group ( P<0.05), there was no statistical difference in LDL-C and HOMA-β CP, HOMA- β INS between the two groups ( P>0.05). Results of bi-variate Logistic regreesion analysis, with NAFLD as dependent variable and other indicators as independent variable, showed that BMI ( OR=1.56, P<0.001), TG ( OR=3.29, P=0.001), LDL-C ( OR=4.11, P=0.021) were risk factors of T2DM complicated by NAFLD. Conclusions:Type 2 diabetes patients with hyperglycemia, hyperlipidemia, high body mass index, insulin resistance more easily have NAFLD.