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目的 探讨正常血糖、糖耐量减低及 2型糖尿病人群体重、血压、血脂、尿酸及胰岛素抵抗指数与非酒精性脂肪肝之间的相互关系。方法 采用口服葡萄糖耐量试验 (OGTT)检测正常血糖、糖耐量减低和 2型糖尿病患者空腹及餐后 2h血糖和胰岛素 ,用HOMA模型计算胰岛素抵抗指数 ,同时测定空腹总胆固醇、甘油三酯和尿酸水平。测量 3组人员身高、体重、血压、腰围及臀围 ,并计算体重指数、腰臀比值。脂肪肝的诊断依据超声影像学检查。结果 与正常血糖组比较 ,糖耐量减低、2型糖尿病组血压、体重指数、腰臀比值、血糖、胰岛素、甘油三酯、总胆固醇、尿酸和胰岛素抵抗指数依次增高 ,差异有显著性 (P <0 .0 0 1)。与糖耐量减低组比较 ,2型糖尿病组血压、血糖、胰岛素、甘油三酯、总胆固醇和胰岛素抵抗指数明显升高 (P <0 .0 5～ 0 .0 0 1) ;腰臀比值和尿酸水平升高 ,体重指数下降 ,但差异无显著性 (P >0 .0 5 )。受试 3组脂肪肝的患病率依次升高 ,差异有显著性 (P <0 .0 5～ 0 .0 0 1)。结论 随着血压、体重指数、腰臀比值、血糖、胰岛素及尿酸升高 ,血脂紊乱和胰岛素抵抗加剧 ,非酒精性脂肪肝的患病率逐渐上升 ,并且非酒精性脂肪肝与上述指标呈正相关。
Objective To investigate the relationship between normal blood glucose, impaired glucose tolerance and body mass, blood pressure, blood lipid, uric acid and insulin resistance index and non-alcoholic fatty liver in type 2 diabetic population. Methods The oral glucose tolerance test (OGTT) was used to detect fasting blood glucose and impaired glucose tolerance and fasting 2h postprandial blood glucose and insulin in type 2 diabetic patients. The insulin resistance index (HOMA) was calculated using HOMA model. Fasting total cholesterol, triglyceride and uric acid . The height, weight, blood pressure, waist circumference and hip circumference of the three groups were measured and the body mass index, waist-hip ratio were calculated. Fatty liver diagnosis based on ultrasound imaging. Results Compared with the normal blood glucose group, the glucose tolerance was decreased. The blood pressure, body mass index, waist-hip ratio, blood glucose, insulin, triglyceride, total cholesterol, uric acid and insulin resistance index increased in turn in type 2 diabetes group with significant difference (P < 0 .0 0 1). The blood pressure, blood glucose, insulin, triglyceride, total cholesterol and insulin resistance index were significantly higher in type 2 diabetes mellitus group than those in glucose tolerance group (P <0.05-0.0.01). The waist-hip ratio and uric acid Level increased, body mass index decreased, but no significant difference (P> 0.05). The prevalence of fatty liver in the three groups increased successively, the difference was significant (P <0.05-0.0001). Conclusion The prevalence of nonalcoholic fatty liver increased with the increase of blood pressure, body mass index, waist-to-hip ratio, blood glucose, insulin and uric acid, dyslipidemia and insulin resistance. And there was a positive correlation between non-alcoholic fatty liver and the above indexes .