| Objective This study was designed to observe the changes about blood glucose,blood pressure,blood lipid,liver function,blood uric acid,25-OH-D3 and other indicators in the elderly type 2 diabetes mellitus(T2DM)patients with or without nonalcoholic fatty liver disease(NAFLD),and to investigate the related factors of nonalcoholic fatty liver disease in elderly patients with type 2 diabetes mellitus and its relationship with 25-OH-D3.Subjective and methods From August 2015 to July 2016,201 cases of elderly patients in the Department of geriatrics and Department of endocrinology of First Hospital Affiliated to Lanzhou University were selected,aged 60-87 years,were divided into two groups,type 2 diabetes with NAFLD group(n = 103)and type 2 diabetes without NAFLD group(n = 98).Using ion chromatography,HPLC,ELISA,B type ultrasonic detection technology,comparing the two groups of patients with age,sex,course of disease,the common complication incidence,body mass index,aspartate aminotransferase,alanine aminotransferase,serum uric acid,serum total cholesterol,three glycerol ester,high density lipoprotein cholesterol,low density lipoprotein cholesterol,fasting blood glucose,2 hour postprandial blood glucose,fasting insulin,fasting C peptide,glycosylated hemoglobin,insulin resistance index,25 hydroxy vitamin D3.SPSS18.0 software was used to analyze the risk factors of NAFLD in elderly patients with T2 DM and the relationship with 25 hydroxy vitamin D3.Results(1)The incidence of hypertension,coronary heart disease and carotid atherosclerosis in elderly T2 DM patients with NAFLD group was higher than that of elderly T2 DM patients without NAFLD group,the difference was statistically significant(P < 0.05).(2)The elderly T2 DM patients with NAFLD,course of disease,body mass index,fasting insulin,fasting C peptide,uric acid,total cholesterol,triglycerides,systolic blood pressure,diastolic blood pressure and insulin resistance index were higher than that of elderly T2 DM patients without NAFLD group,the difference was statistically significant(P < 0.05).The levels of high density lipoprotein cholesterol and 25-hydroxy vitamin D3 were lower than of elderly T2 DM patients without NAFLD group,the difference was statistically significant(P < 0.05).(3)The incidence of vitamin D deficiency in the elderly T2 DM patients with NAFLD group was significantly higher than that in elderly T2 DM patients without NAFLD group,the difference was statistically significant(P < 0.05).(4)The 25 hydroxyvitamin D3 levels which in elderly T2 DM patients with NAFLD group was negatively correlated with age,fasting blood glucose,2 hour postprandial blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,low density lipoprotein cholesterol,insulin resistance index,the differences were statistically significant(P < 0.05).(5)The results of multivariate logistic regression analysis showed that,BMI(OR=1.188,P < 0.05),TG(OR=1.660,P < 0.05),HOMA-IR(OR=1.660,P < 0.001)were risk factors for elderly patients with T2 DM combined with NAFLD.HDL and 25-OH-D3 are protective factors of T2 DM in elderly patients with NAFLD.Conclusions(1)Elderly patients with T2 DM combined with NAFLD had more risk factors of cardiovascular and cerebrovascular complications in elderly patients with T2 DM than those with NAFLD,and the incidence of cardiovascular and cerebrovascular complications was significantly higher.(2)Compared with the elderly T2 DM patients without NAFLD,the levels of vitamin D3 were significantly lower in patients with NAFLD.25 vitamin D3 deficiency may increase the prevalence of nonalcoholic fatty liver disease.Objective to investigate the relationship between 25 hydroxy vitamin D3 and nonalcoholic fatty liver disease,and to find out the early complications of heart and cerebrovascular disease,and to intervene and treat it in time. |
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