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目的研究2型糖尿病合并亚临床甲状腺机能减退症(亚甲减)与非酒精性脂肪性肝病的关系。方法选择2013年1月-2013年6月某院2型糖尿病患者333例。将患者分为NAFLD组(210例)和非NAFLD组(123例),对两组的血脂和胰岛素抵抗指标、生化肝功和甲状腺功能进行比较。还将患者分为甲状腺功能(甲功)正常组和亚甲减组,对两组合并非酒精性脂肪性肝病的比例进行比较。明确2型糖尿病合并非酒精性脂肪性肝病的危险因素。结果 NAFLD组的稳态模型胰岛素抵抗指数和促甲状腺激素分别为2.22(1.41,3.58)和2.32±1.93m IU/L,均明显高于非NAFLD组的1.05(0.71,1.60)和1.75±1.27m IU/L(P均<0.01)。亚甲减组中非酒精性脂肪性肝病的患病率为87.5%(21/24),明显高于甲功正常组的61.2%(189/309)(P=0.018)。身体质量指数、甘油三脂、稳态模型胰岛素抵抗指数和促甲状腺激素均是T2DM合并非酒精性脂肪性肝病的危险因素,比值比分别为1.127、1.453、1.985和1.248。结论 2型糖尿病合并亚甲减患者中非酒精性脂肪性肝病的患病率明显高于甲功正常的患者,稳态模型胰岛素抵抗指数和促甲状腺激素升高均是2型糖尿病合并非酒精性脂肪性肝病的危险因素。
Objective To investigate the relationship between type 2 diabetes mellitus and subclinical hypothyroidism (methylene hypothyroidism) and non-alcoholic fatty liver disease. Methods From January 2013 to June 2013, 333 cases of type 2 diabetes in a hospital were selected. The patients were divided into NAFLD group (n = 210) and non-NAFLD group (n = 123). The levels of lipids, insulin resistance, biochemical liver function and thyroid function were compared between the two groups. Patients were also divided into normal thyroid function (thyroid function) and sub-arm hypothyroidism to compare the two groups of non-alcoholic fatty liver disease ratio. Clear type 2 diabetes combined with non-alcoholic fatty liver disease risk factors. Results The steady state insulin resistance index and thyrotropin of NAFLD group were 2.22 (1.41, 3.58) and 2.32 ± 1.93m IU / L, respectively, which were significantly higher than those of NAFLD group 1.05 (0.71,1.60) and 1.75 ± 1.27m IU / L (P <0.01). The prevalence of non-alcoholic fatty liver disease in the subgroup was 87.5% (21/24), significantly higher than 61.2% (189/309) in patients with normal thyroid function (P = 0.018). Body mass index, triglyceride, homeostasis model insulin resistance index and thyrotropin were risk factors for T2DM with non-alcoholic fatty liver disease, with odds ratios of 1.127, 1.453, 1.985 and 1.248, respectively. Conclusions The prevalence of nonalcoholic fatty liver disease in type 2 diabetic patients with methylenetetrazole is significantly higher than that in patients with normal thyroid function. The steady-state model of insulin resistance index and thyroid-stimulating hormone are both type 2 diabetes mellitus with non-alcoholic Risk factors for fatty liver disease.