Analysis Of Related Metabolic Indexes In Type 2 Diabetic Patients With Nonalcoholic Fatty Liver Disease

Objective(1)The purpose of this paper was to analyze the related metabolic indexes of patients with type 2 diabetes mellitus(T2DM)and type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease(NAFLD),then to compare the differences of the related metabolic indexes between the two groups of patients.(2)Further to investigate the related factors of NAFLD in patients with type 2 diabetes mellitus and pay attention to the relationship between microalbuminuria,TSH and NAFLD in patients with type 2 diabetes mellitus.Methods(1)General information collection: all subjects completed a unified questionnaire,including gender,age,course of disease,past medical history,current disease and drug use history,etc.(2)Physical examination: after fasting for a period of 8 to 12 h,the physical examination physicians measured the height,weight,waist circumference and hip circumference in the morning,and measured the blood pressure in the quiet state.The above indexes were measured for 3 times and took the average.(3)Laboratory indicators: elbow venous blood samples were sent to test,measurement indicators including blood routine,fasting blood glucose and blood lipid index [three triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein cholesterol(LDL),andtotal cholesterol,alaine transaminase(ALT),aspartate transaminase(AST).Determination of glycosylated hemoglobin,microalbuminuria,thyroid stimulating hormone,fasting insulin.Calculate homeostasis model assessment of insulin resistance(HOMA-IR)[level of fasting blood glucose(mmol/L)* fasting insulin level(mU/L)/22.5] to evaluate insulin resistance.(4)Ultrasound: One experienced physician of our hospital conduct the liver ultrasound,ultrasound diagnosis standard refer to the standard of Chinese Medical Association of alcoholic fatty liver disease hepatology revised in 2010.Meet the following three in two regarded as fatty liver:(1)Diffuse enhancement of liver near-field echo("bright liver"),stronger than the echo of the kidney;(2)Structure of intrahepatic duct is not clear;(3)Far field echo of liver decays.Results(1)Compared to T2 DM group,the patient of T2DM+NAFLD group' body weight,body mass index(BMI),waist hip ratio were significantly increased(P<0.05).The differences of age,duration,height,systolic blood pressure and diastolic blood pressure between the two groups were not statistically significant(P>0.05).(2)Compared to T2 DM group,T2DM+NAFLD group' triglyceride(TG),total cholesterol(TC),alanine aminotransferase(ALT)and aspartate aminotransferase(AST),microalbuminuria,thyroid stimulating hormone(TSH)and insulin resistance index(HOMA-IR)were significantly increased(P <0.05);and the differences of low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),red blood cells,white blood cells,platelets,hemoglobin A1c(HbA1c)between the two groups have no statistically significant(P>0.05).(3)Making whether has NAFLD as the dependent variable,and age,disease duration,systolic blood pressure,low density lipoprotein cholesterol,high density lipoprotein cholesterol,red blood cells,white blood cells,platelets,HbA1 c,HOMA-IR,height,weight,BMI,WHR,diastolic blood pressure,triglyceride,total cholesterol,alanine aminotransferase,aspartate aminotransferase,albumin,TSH as independent variables analyzed by single factor Logistic regression analysis,showed that body weight,body mass index,waist hip ratio,the total cholesterol,triglyceride,microalbuminuria,TSH are related to NAFLD(P<0.05).(4)To exclude the confounding factors,the multivariate showed that microalbuminuria,TSH,BMI,waist to hip ratio are still the main risk factors for NAFLD(P<0.05).Conclusion(1)Compared to T2 DM group,T2DM+NAFLD group' body weight,body mass index(BMI),waist hip ratiotriglyceride(TG),total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),microalbuminuria,thyroid stimulating hormone(TSH)and insulin resistance index(HOMA-IR)were significantly increased,suggesting that obesity,fat redistribution,lipid disorders,liver function and insulin resistance weresusceptible factors patients of the occurrence of NAFLD in patient with T2 DM.(2)Microalbuminuria,TSH,BMI,waist to hip ratio were independent factors of NAFLD in patients with T2 MD.Microalbuminuria and TSH are closely related to the occurrence of NAFLD in patients with type 2 diabetes mellitus.It is suggested that these two indexes can be used to prevent the occurrence of T2 DM in patients with NAFLD by early screening and intervention.