首页|基于胰岛素抵抗替代指标评估非肥胖2型糖尿病患者NAFLD的价值

基于胰岛素抵抗替代指标评估非肥胖2型糖尿病患者NAFLD的价值

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  • NETL
  • NSTL
  • 万方数据
目的 探讨胰岛素抵抗替代指标评估非肥胖 2 型糖尿病(T2DM)患者发生非酒精性脂肪性肝病(NAFLD)的价值.方法 选取 2020 年 5 月至 2022 年 5 月张家港澳洋医院收治的 201 例T2DM患者为研究对象,其中 119 例合并NAFLD.119 例患者中 103 例患者为非进展性肝纤维化者.收集患者基本资料,分析T2DM患者发生NAFLD的影响因素和胰岛素抵抗替代指标预测T2DM患者发生NAFLD的价值,统计不同病情NAFLD患者血清胰岛素抵抗替代指标情况.结果 多因素Logistic回归分析显示稳态模型评估胰岛素抵抗指数(HOMA-IR)(OR=3.931,95%CI:1.618～9.555)、甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)(OR=4.063,95%CI:1.672～9.875)、TG-葡萄糖指数(TyG)(OR=3.999,95%CI:1.645～9.718)、TyG-体重指数(TyG-BMI)(OR=3.823,95%CI:1.573～9.291)、内脏脂肪指数(VAI)(OR=3.777,95%CI:1.554～9.180)水平是T2DM患者发生NAFLD的影响因素(P<0.05).受试者操作特征(ROC)曲线分析结果显示,HOMA-IR、TG/HDL-C、TyG、TyG-BMI、VAI 预测 T2DM 患者发生 NAFLD 的灵敏度分别为 71.43%、74.79%、71.43%、73.95%、70.59%,特异度分别为 70.73%、80.49%、73.17%、79.27%、70.73%,AUC分别为 0.744、0.758、0.742、0.777、0.724.进展性肝纤维化组的 HOMA-IR、TG/HDL-C、TyG、TyG-BMI水平均高于非进展性肝纤维化组(P<0.05).结论 HOMA-IR、TG/HDL-C、TyG、TyG-BMI、VAI与T2DM患者发生 NAFLD 有关,胰岛素抵抗替代指标预测 T2DM 患者发生 NAFLD 的效能良好,且胰岛素抵抗替代指标可能与NAFLD病情有关.
Evaluation of NAFLD in non-obese type 2 diabetes mellitus patients based on insulin resistance proxies
Objective To investigate the value of proxies for insulin resistance in evaluating non-alcoholic fatty liver disease visceral fat index(VAI)(OR=3.777,95%CI:1.554-9.180)were the influencing factors of NAFLD in T2DM patients(all P<0.05).Receiver operating character(ROC)curve showed that the sensitivities of HOMA-IR,TG/HDL-C,TyG,TyG-BMI and VAI in predicting NAFLD in T2DM patients was 71.43%,74.79%,71.43%,73.95%and 70.59%,specificity were 70.73%,80.49%,73.17%,79.27%and 70.73%,and AUC values were 0.744,0.758,0.742,0.777 and 0.724,respectively.The levels of HOMA-IR,TG/HDL-C,TyG and TyG-BMI in the progressive liver fibrosis group were higher than those in the non-progressive liver fibrosis group(all P<0.05).Conclusion Homa-IR,TG/HDL-C,TyG,TyG-BMI and VAI are associated with NAFLD in T2DM patients.Insulin resistance proxies show good efficacy in predicting NAFLD in T2DM patients,and it may be related to the severity of NAFLD.

Type 2 diabetes mellitusInsulin resistance proxiesNon-alcoholic fatty liver disease

李梦婷、陆璧、张彦、蒋琳

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215600 江苏 苏州,张家港澳洋医院风湿免疫内分泌科

2型糖尿病 胰岛素抵抗替代指标 非酒精性脂肪性肝病

2024

10.3969/j.issn.1009-0754.2024.07.015

海军医学杂志
海军医学研究所

海军医学杂志

CSTPCD
影响因子：0.518
ISSN：1009-0754
年,卷(期)：2024.45(7)