非酒精性脂肪性肝病合并2型糖尿病患者脂肪受控衰减参数及肝脏硬度值的变化

肝脏 ›› 2022, Vol. 27 ›› Issue (3): 355-357.

非酒精性脂肪性肝病合并2型糖尿病患者脂肪受控衰减参数及肝脏硬度值的变化

魏建东, 苟小军, 陈远卓, 施巍

201900 上海市宝山区中西医结合医院急诊科(魏建东,施巍),检验科(苟小军);同济大学附属第十人民医院急诊科(陈远卓)

收稿日期:2021-05-30 出版日期:2022-03-31 发布日期:2022-05-31
通讯作者: 施巍,Email:SW1208@sohu.com
基金资助:
国家自然科学基金面上项目(82074083)

Changes of fat controlled attenuation parameter and liver stiffness measurement in patients with nonalcoholic fatty liver disease complicated with type 2 diabetes mellitus

WEI Jian-dong¹, GOU Xiao-jun², CHEN Yuan-zhuo³, SHI Wei

1. Department of Emergency, Baoshan Integrated Traditional Chinese and Western Medicine Hospital, Shanghai 201900, China;
2. Laboratory, Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201900, China;
3. Department of Emergency, the Tenth People's Hospital Affiliated to Tongji University, Shanghai 200072, China

Received:2021-05-30 Online:2022-03-31 Published:2022-05-31
Contact: SHI Wei,Email: Shenghuipingnx@163.com

摘要/Abstract

摘要： 目的探讨非酒精性脂肪性肝病(NAFLD)合并2型糖尿病(T2DM)患者肝脏脂肪受控衰减参数(CAP)以及肝脏硬度值(LSM)的变化。方法选择2018年1月至2020年12月T2DM患者128例(男57例,女71例),年龄(52.6±8.2)岁。其中合并NAFLD44例,单纯T2DM组84例。计量资料采用t检验,计数资料采用卡方检验。结果合并NAFLD组ALT、AST、TG、LDL、FBG、FINS及HbA1c分别为(86.3±10.5)U/L、(82.9±8.3)U/L、(2.5±0.7)mmol/L、(4.4±1.3)mmol/L、(9.6±1.2)mmol/L、(5.2±1.5)μIU/μL及(8.4±0.9)%,与单纯T2DM组(38.2±4.8)U/L、(39.7±3.8)U/L、(1.6±0.5)mmol/L、(2.3±0.8)mmol/L、(7.2±1.0)mmol/L、(3.6±1.1)μIU/μL及(6.9±0.8)%比较,差异有统计学意义(均P<0.05);NAFLD组、单纯T2DM组LSM分别为(9.3±2.4)kPa、(5.7±1.1)kPa,差异有统计学意义(P<0.05);NAFLD组、单纯T2DM组CAP分别为(224.2±36.4)dB/m、(121.4±24.9)dB/m,差异有统计学意义(P<0.05)。NAFLD合并T2DM患者各肝脂肪变程度G0至G3级分别为7、14、13及10例。G2、G3级CAP值高于G0、G1级,G3级CAP值高于G2级(均P<0.05)。NAFLD合并T2DM患者各肝纤维化分期F0至F4期为6、11、13、8及6例。F3、F4期LSM值均高于F0、F1及F2期(P<0.05)。结论 T2DM和NAFLD之间有明显的相关性,对T2DM和NAFLD进行早期筛查对疾病的治疗及预后具有积极的作用。

关键词: 非酒精性脂肪性肝病, 2型糖尿病, 脂肪受控衰减参数, 肝脏硬度值

Abstract: Objective To explore the changes of liver fat controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) in patients with nonalcoholic fatty liver disease(NAFLD) complicated with type 2 diabetes mellitus (T2DM), and to provide clinical basis for early NAFLD screening of diabetic patients.Methods From January 2018 to December 2020, 128 patients with T2DM (58 males and 70 females) were reviewed, with age of (52.6±8.2) years. The diagnosis of NAFLD and T2DM was in line with the guidelines, and the patients with T2DM were divided into NAFLD group and single T2DM group according to whether they were complicated with NAFLD. T test was used for measurement data, and Chi-square test was used for counting data.Results There were 44 cases and 84 cases in NAFLD group and single T2DM group in 128 patients with T2DM. Comparative data showed that ALT, AST, TG, LDL, FBG, FINS and HbA1c in NAFLD group were (86.3±10.5) U/L, (82.9±8.3) U/L, (2.5±0.7) mmol/L, (4.4±1.3) mmol/L, (9.6±1.2) mmol/L, (5.2±1.5) uIU/uL and (8.4±0.9)%, compared with single T2DM group [(38.2±4.8) U/L, (39.7±3.8) U/L, (1.6±0.5) mmol/L, (2.3±0.8) mmol/L, (7.2±1.0) mmol/L, (3.6±1.1) uIU/uL and (6.9±0.8)%], the difference was statistically significant (P<0.05). The LSM of NAFLD group and single T2DM group were (9.3±2.4) kPa and (5.7±1.1) kPa, with statistical significance difference (P<0.05). The levels of CAP in NAFLD group and single T2DM group were (224.2±36.4) dB/m and (121.4±24.9)dB/m, with statistical significance difference (P<0.05). According to the degree of hepatic steatosis, it could be divided into Grade 0 to Grade 3 (G0-G3). In T2DM patients with NAFLD, there were 7 patients with G0, 14 with G1, 13 with G2, 10 with G3. The CAP values of G2 and G3 were significantly higher than those of G0 and G1 respectively (P<0.05), while the CAP values of G3 were significantly higher than those of G2 (P<0.05). According to the degree of liver fibrosis, it could be divided into F0 to F4. In T2DM patients with NAFLD, there were 6 patients with F0, 11 with F1, 13 with F2, 8 with F3, 6 with F4. LSM values in F3 and F4 were significantly higher than those in F0, F1 and F2 (P<0.05).Conclusion There is an obvious correlation between T2DM and NAFLD. Early screening of T2DM and NAFLD has a positive impact on the treatment and prognosis of the disease.

Key words: Nonalcoholic fatty liver disease, Type 2 diabetes mellitus, Controlled attenuation parameter, Liver stiffness measurement

魏建东, 苟小军, 陈远卓, 施巍. 非酒精性脂肪性肝病合并2型糖尿病患者脂肪受控衰减参数及肝脏硬度值的变化[J]. 肝脏, 2022, 27(3): 355-357.

WEI Jian-dong, GOU Xiao-jun, CHEN Yuan-zhuo, SHI Wei. Changes of fat controlled attenuation parameter and liver stiffness measurement in patients with nonalcoholic fatty liver disease complicated with type 2 diabetes mellitus[J]. Chinese Hepatolgy, 2022, 27(3): 355-357.

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