目的 探讨社区 2 型糖尿病(T2DM)患者非酒精性脂肪性肝病(NAFLD)和代偿期进展性慢性肝病(cACLD)患病情况及其影响因素。方法 2021 年7 月～9 月在邢台市 5 个社区调查糖尿病患者，采用现场问卷调查，记录身高、体质量、血压、血糖和血脂，使用FibroScan©瞬时弹性成像仪行肝脏硬度检测(LSM)和受控衰减参数(CAP)检测。采用二元Logistic回归分析影响T2DM合并重度NAFLD的危险因素。结果 本研究纳入登记在册的 946 例社区T2DM患者，女性占 64。5％，显著多于男性(35。5％，P<0。05);合并 NAFLD 患者 664 例(70。2％)，其中重度 334 例(50。3％)，中度198 例(29。8％)，轻度 132 例(19。9％);T2DM合并cACLD者 94 例(9。9％)，正常体质量、超重和肥胖人群cACLD患病率分别为6。1％、10。5％和 17。6％;差异性分析显示，超重和肥胖、高血脂、冠心病和糖尿病病程是社区T2DM合并不同程度NAFLD的影响因素(P<0。05)，超重和肥胖、高血脂和冠心病是社区T2DM合并cACLD的影响因素(P<0。05);二元Logistic回归分析显示，BMI是社区T2DM合并重度NAFLD的独立影响因素(P<0。05)。结论 本组T2DM合并NAFLD患病率较高，而cACLD患病率也达到9。9％，应予以重视。
Objective This study was conducted to investigate the prevalence of non-alcoholic fatty liver diseases(NAFLD)and compensated advanced chronic liver disease(cACLD)in patients with type 2 diabetes mellitus(T2DM).Methods The patients with T2DM from 5 communities in Xingtai City were surveyed between July and September 2021,and an well-designed questionnaires were applied to record the height,body weight,blood pressure,blood glucose and blood lipids,and the liver stiffness measurement(LSM)and controlled attenuation parameter(CAP)were performed by using FibroScan©elastography.The binary Logistic regression analysis was applied to reveal the risk factors of severe NAFLD.Result This study included946 patients with T2DM in five communities,and the female accounted for 64.5％,much higher than 35.5％in male(P<0.05);the concomitant NAFLD was found in 664 cases(70.2％),including severe in 334 cases(50.3％),moderate in 198(29.8％)and mild in 132 cases(19.9％);the concomitant cACLD was found in 94 cases(9.9％),and the percentages of cACLD in normal body weight,overweight and obese individuals were 6.1％,10.5％and 17.6％;the univariate Logistic regression analysis showed that the overweight,obesity,hyperlipidemia,coronary heart disease,and diabetic courses were different between persons with severe NAFLD and those without(P<0.05),and the overweight,obesity,hyperlipidemia,coronary heart disease were different in patients with cACLD and those without(P<0.05);the binary Logistic regression analysis showed that the body mass index was the independent risk factor impacting the concomitant existence of NAFLD in patients with T2DM(P<0.05).Conclusion The prevalence of NAFLD in our series of patients with T2DM is high,and the concomitant cACLD is also reached to 9.9％,which should be appropriately dealt with.
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