2型糖尿病并发非酒精性脂肪肝的危险因素及对肺功能的影响

目的探讨2型糖尿痛（T2DM）患者并发非酒精性脂肪肝 （ non-alcoholic fatty liver disease, NAFLD）的危险因素及这些危险因素对肺功能的影响。方法选取住院T2DM患者78例，进行磁共振肝脂肪定量及肺功能检查，根据肝脂肪定量结果分为NAFLD组和非NAFLD组，比较两组肺功能情况，对相关因素进行多因素线性回归分析。结果40例住院T2DM患者合并NAFLD，38例未合并NAFLD。NAFLD组体质指数（BMI）、收缩压（SBP）、血三酰甘油（TG）、丙氨酸氨基转移酶（ALT）、r-谷氨酰转移酶（GGT）显著高于非NAFLD组（P〈0．05），肺活量（VC）、用力肺活量（FVC）、一秒用力呼气流量（FEVl）、一秒率（FEVl／FVC）、肺一氧化碳弥散量（DLCO）均低于非NAFLD组，但差异无统计学意义（P〉0．05）。T2DM患者肝脂肪定量与SBP（r=0．437，P〈0，05）、TG（r=0．435，P〈0．05）、GGT（r=0．469，P〈0．05）呈正相关，与肺功能指标FVC（r=-0．467，P〈0．05）呈负相关。结论SBP、TG、GGT为2型糖尿病合并NAFLD的独立危险因子，NAFLD与糖尿病肺功能损害密切相关。

Risk factors of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes and their relation to respiratory dysfunction

Objective To investigate the risk factors of non-alcoholic fatty liver disease （NAFLD） in patients with type 2 diabetes and their relation to respiratory dysfunction. Methods Pulmonary functions were assessed in 78 type 2 diabetic patients were enrolled in the study, including 40 patients complicated with NAFLD and 38 without NAFLD. Liver fat quantification was measured with MRI, and pulmonary function tests were performed. Results Body mass index, systolic blood pressure, triglyceride, ALT and GGT were signif- icantly increased in NAFLD group compared to non-NAFLD group （ P 〈 0.05 ）. There were no significant differences in VC, FVC, FEV1, FEV1/FVC and DLCO between two group （P 〉0.05 ）. Liver fat quantification was positively correlated with SBP, TG and GGT （ P 〈 0.05 ）, and negatively correlated with FVC （ P 〈 0.05 ）. Conclusion SBP, TG and GGT are indep- endent risk factors for NAFLD in type 2 diabetic patients. NAFLD is closely associated with pulmonary complications in type 2 diabetes mellitus.