Related Factors Of Type 2 Diabetes With Nonalcoholic Fatty Liver Disease And Liver Fibrosis

Background In recent years,with the economic development and lifestyle changes,the prevalence of diabetes increased gradually in the world,the type 2 diabetes diabetes accounted for more than 90%,according to statistics to 2030,the whole world will exceed 300 million in patients with diabetes,insulin resistance is the main pathogenesis of type 2 diabetes.Nonalcoholic fatty liver disease(NAFLD)is a metabolic disease that excludes the diffuse fatty degeneration of liver cells caused by ethanol,virus and other etiological factors.It encompasses a spectrum of hepatic disorders ranging from simple steatosis to steatohepatitis(non alcoholic steatohepatitis,NASH),hepatic fibrosis,cirrhosisand and liver cancer.Type 2 diabetes,due to insulin resistance,can promote the development and development of nonalcoholic fatty liver disease.Non alcoholic fatty liver disease,due to excessive fatty acid deposition in liver cells,aggravates insulin resistance,making blood glucose of type 2 diabetes patients more difficult to control,and more likely to promote the development of diabetic complications.The two form a vicious circle.Therefore,the early diagnosis and intervention of non-alcoholic fatty liver disease is of great significance to the development of liver fibrosis.Objectives To investigate the risk factors of type 2 diabetes mellitus and non-alcoholic fatty liver disease in hospitalized patients,and analyze the related factors of liver fibrosis in type 2 diabetes mellitus and non-alcoholic fatty liver disease.Methods From January 2016 to October 2017,we choose 182 patients with type 2 diabetic who are for the first time treated in hospitalized in Department of endocrinology of Third Affiliated Hospital of Xinxiang Medical College,recording the general clinical data of all the people,such as gender,age,duration of diabetes,height(cm),weight(kg),blood pressure(mmHg),collected fasting blood glucose,fasting insulin,C peptide,glycosylated hemoglobin,ALT and AST blood index analysis.According to the results of abdominal ultrasound,182 patients were divided into type 2 diabetes group(T2DM,n=66),and type 2 diabetes complicated with nonalcoholic fatty liver disease group(T2DM + NAFLD group,n=116),According to the liver fibrosis score,T2DM+NAFLD was divided into A group exclude liver fibrosis group: NFS<-1.455,group B middle state group:-1.455≤NFS ≤ 0.676,C group progressive liver fibrosis group: NFS>0.676.The SPSS19.0 software was used to compare the two groups of T2 DM and T2DM+NAFLD.The risk factors of type 2 diabetes with non-alcoholic fatty liver disease were analyzed,and the general data and biochemical data of the groups of A,B and C were compared,and the related factors of the liver fibrosis in type 2 diabetes with non-alcoholic fatty liver disease were analyzed.Results(1)Compared with T2 DM group,T2DM+NAFLD had higher body mass index(BMI)[23.66±1.73 vs.27.34±3.16],fasting blood glucose(FBG)[8.69±2.14 vs.10.46±3.09],cholesterol(TC)[4.39±1.00 vs.4.84±0.86],triglyceride(TG)[1.28(1.02,1.68)vs.1.92(1.50,2.64)],alanine aminotransferase(ALT)[18(15.00,24.50)vs.24(16.00,34.25)],fasting insulin(FINS)[7.29±1.89 vs.11.23±4.42],homeostasis model assessment insulin resistance index(HOMA-IR)[2.74±0.72 vs.5.06±1.85],glycosylated hemoglobin(HbA1c)[8.51±1.48 vs.9.39±2.29],fasting C peptide(FC-P)[1.42±0.56 vs.1.74±0.87],the difference was statistically significant(P < 0.05).Two Logistic regression analysis showed that BMI and TG were independent risk factors for type 2 diabetes with nonalcoholic fatty liver disease.(2)Binary Logistic regression showed that BMI and TG were independent risk factors for diabetes with nonalcoholic fatty liver disease.(3)Spearman correlation analysis showed that NFS was positively related to the course of diabetes,FBG and HOMA-IR,and was negatively correlated with TC and LDL-C.(4)Ordinal logistic regression,the results show that the course of diabetes and the decline of cholesterol are the risk factors of liver fibrosis.Conclusions 1.BMI and TG are independent risk factors for diabetes with nonalcoholic fatty liver disease,and lifestyle intervention is of great significance for non-alcoholic fatty liver disease.2.The course of diabetes and TC reduce are the risk factors for liver fibrosis.In clinical practice,non-alcoholic fatty liver disease should be paid close attention to to prevent the development of fibrosis.