·糖尿病与脂质代谢·

　　2型糖尿病患者非酒精性脂肪肝病与血清尿酸水平相关性的研究

　　李文斌 李健 张微 刘盈 岳丽霞 徐积兄

　　【摘要】 目的 探讨T2DM患者非酒精性脂肪肝病(NAFLD)与血清尿酸(SUA)水平的相关性。 方法 选取T2DM患者790例，检测临床实验指标，采用腹部彩色多普勒超声检查诊断NAFLD。根据是否合并NAFLD分为2组：合并NAFLD (NAFLD)组219例和未合并NAFLD(N-NAFLD)组571例;根据SUA水平分为4组：Q1组202例(<230 µmol/L)、Q2组194例(231～287 µmol/L)、Q3组194例(288～350 µmol/L)和Q4组200例(>350 µmol/L)。 结果 NAFLD组BMI、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、TG、TC、LDL-C和SUA等均高于N-NAFLD组(P均<0.05);NAFLD组年龄和HDL-C低于N-NAFLD组(P均<0.05);其余指标两组间的差异无统计学意义(P>0.05)。Q1、Q2、Q3和Q4组T2DM患者合并NAFLD的患病率分别为16.8%(34/202)、22.6%(44/194)、30.9%(60/194)和40.5%(81/200)，四组间差异有统计学意义(c2=31.71，P<0.001);经校正相关因素后，Q4组患者NAFLD患病风险仍高于Q1组患者(OR 3.19，95%CI 1.38～7.39)。 结论T2DM患者NAFLD与SUA具有显著相关性，高SUA水平可能是T2DM患者NAFLD发生的独立相关因素。

　　【关键词】糖尿病，2型;血清尿酸;非酒精性脂肪肝病

Relationship between serum uric acid concentration and non-alcoholic fatty liver disease in T2DM patients LI Wen-bin, LI Jian, ZHANG Wei, et al. Department of Endocrinology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China

　　Corresponding author: XU Ji-xiong, E-mail:axujixiong@163.com

　　【Abstract】 Objective To investigate the relationship between serum uric acid (UA) levels and non-alcoholic fatty liver disease (NAFLD) in T2DM patients. Methods A total of 790 T2DM subjects were enrolled in this study. Clinical experiment indices were detected. The abdominal Doppler ultrasonic examination was applied for diagnosis of NAFLD. The patients were divided into NAFLD group (n=219) and non-NAFLD group (n=571). According to the UA levels, categorized as quartiles, the patients were divided into four groups: Q1 group (<230, n=202), Q2 group (231～287, n=194), Q3 group (288～350, n=194), and Q4 group (>350, n=200). Results The Body mass index (BMI), analanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), and UA in the NAFLD group were significantly higher than those in the non-NAFLD group (P<0.05). The age and high density lipoprotein cholesterol (HDL-C) in the NAFLD group were significantly lower than those in the non-NAFLD group (P<0.05). There were no statistical differences of other indexes between them. The prevalence of NAFLD in Q1, Q2, Q3, and Q4 groups was 16.8% (34/202), 22.6% (44/194), 30.9% (60/194) and 40.5% (81/200) respectively, and the differences among the four groups were statistically significant(c2=31.71, P<0.001). After adjusting the related factors, the risk for prevalence of NAFLD in Q4 group was still significantly higher than that in Q1 group [OR (95%CI):3.19 (1.38-7.39)]. Conclusion The serum uric acid level in subjects with T2DM was significantly related with NAFLD. A higher SUA level may be one of the factors independently related to NAFLD in T2DM patients.

　　【Key words】 Diabetes mellitus, type 2; Serum uric acid; Non-alcoholic fatty liver disease (NAFLD)