Clinic Analysis Of Non-alcoholic Fatty Liver In Patients With Type 2 Diabetes Mellitus

Morden life style and poor healthy awareness made people'sactivity become little and little. Unreasonable diet such as highercalorific, higher fat, higher protein and lower fibrin lead tooverweight and fat which cause increasing rate of diabetes,hypertension, hyperlipemia. With the increase of diabetes mellitus'sincidence rate and ultrasonography's popularization, the detectionrate of the type 2 diabetes affiliated with non-alcoholic. Nonalcoholicfatty liver is the third of hepatopathy, which are danger to people'shealth, and it is close to the decompensation of liver cirrhosis. Inrecent years, many study indicate that insulin resistance is thebasement of metabolic syndrome's pathology. Insulin resistance anddisturbance of carbohydrate metabolism mybe the primarily cause ofthe fatty liver.Obejective To Study and analysis the relationship betweeninsulin resistance and the non-alcoholic fatty liver in patients withType2 diabetes mellitus. Method The patients were selected in ourhospital from March,2004 to March,2005. A total of 42(20 malesand 22 females) patients of type 2 diabetes with non-alcoholic fattyliver and 30(25 males and 21 females) type 2 diabetes without fattylivers were entered into study. They must be fit these standard: (1)the diagnosis standard made in 1999 of WHO;(2) excluded patientswhose therapy by insulin;(3) excluded patients who drunk or thetotle alcohol more than 40g every week;and excluded patients whohad virus hepatitis, drug-induced liver disease, Wilson, parenteralnutrition, autoimmune liver disease, serious infection, the acutecomplication of diabetes mellitus;(4) fit the diagnosis standard offatty liver. All people in the study were measured body height,weight, waistline, blood pressure, making electrocardiogram andcalculated BMI (calculated as weight in kilograms divided by heightin meters squared). After the subjects had fasted 12 hours at the timeexamination, fasting and post-prandial glucose levels, serum insulin,C-Peptide, cholesterol-total, serum triglycerides, serum LDLcholesterol, serum HDL cholesterol, apolipoprotein A1,apolipoprotein B, aspartate amino transferase, alanineaminotransferase, glycosylated hemoglobin. Insulin resistance index(HOMA-IR) = FBG×FIN/22.5,Insulin sensitiveness index(ISI) = 1/FBG ×FIN. Results 1.There was no difference in age, sex andcourse of disease in the two group (P>0.05);compared to controlgroup, patients with non-alcoholic fatty liver disease werecharacterized by BMI and waistline (P<0.01);2. Individuals withnon-alcoholic fatty liver disease had higher serum triglycerides,serum LDL cholesterol, apolipoprotein B, alanine aminotransferase(P<0.01),and higher fasting glucose , post-prandial glucose,cholesterol – total, but there was no difference in serum HDLcholesterol, apolipoprotein A1, aspartate amino transferase(P>0.05);3.the patients with non-alcoholic fatty liver had higher fasting insulin,C-Peptide, post-prandial C-Peptide levels, insulin resistance indexthan controlgroup and lower insulin sensitiveness index (P<0.01).Their insulin sensitivity index was lower than the group without fattyliver(P>0.05). 4,the patients with non-alcoholic fatty liver hadhigher rate in hypertension and coronary artery disease. ConclusionThe patients of type 2 diebetes with fatty liver have obvious lipidmetabolic disturbance ,insulin resistance and overweight ,and it havehigh rate in complications of coronary artery disease andhypertension. So, it is very necessary to improve insulin resistancebecause it is play an important role in occurring of non-alcoholicfatty liver, in spite of reasonable diet, movement, control bodyweight and adjust blood fat.