老年2型糖尿病合并非酒精性脂肪性肝病與25-OH-D3的相關(guān)性研究
發(fā)布時間：2018-07-28 14:04
【摘要】：目的本研究旨在通過觀察老年2型糖尿病(T2DM)患者合并或不合并非酒精性脂肪性肝病(NAFLD)時,血糖、血壓、血脂、肝功、血尿酸、25-OH-D3等指標的變化,探討老年2型糖尿病患者發(fā)生非酒精性脂肪性肝病的相關(guān)影響因素及其與25-OH-D3的關(guān)系。方法收集2015年8月至2016年7月蘭州大學第一醫(yī)院老年病科及內(nèi)分泌科住院患者201例,年齡在60-87歲,分為老年T2DM合并(103例)或不合并(98例)NAFLD兩組。采用離子層析高效液相、酶聯(lián)免疫、B型超聲檢測等技術(shù)手段,比較兩組患者的年齡構(gòu)成、性別、病程、常見合并癥患病情況、體重指數(shù)(BMI)、天冬氨酸氨基轉(zhuǎn)移酶(AST)、丙氨酸氨基轉(zhuǎn)移酶(ALT)、血尿酸(UA)、甘油三酯(TG)、血清總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)、糖化血紅蛋白(HbAlc)、空腹血糖(FBG)、空腹胰島素(FINS)、空腹C肽、餐后2小時血糖(2hPBG)、胰島素抵抗指數(shù)(HOMA-IR)、25羥基維生素D3(25-OH-D3)。應用SPSS18.0軟件進行統(tǒng)計學分析,探討老年T2DM患者發(fā)生NAFLD的相關(guān)危險因素以及與25-OH-D3的關(guān)系。結(jié)果(1)老年T2DM合并NAFLD組的患者發(fā)生高血壓、冠心病、頸動脈粥樣硬化的機率均高于老年T2DM不合并NAFLD組的患者,差異具有統(tǒng)計學意義(P0.05)。(2)老年T2DM合并NAFLD組的患者,其糖尿病患病病程、BMI、FINS、C肽、UA、TC、TG、SBP、DBP、HOMA-IR均高于老年T2DM不合并NAFLD組患者,差異具有統(tǒng)計學意義(P0.05)。HDL-C、25-OH-D3水平低于老年T2DM不合并NAFLD組患者,差異具有統(tǒng)計學意義(P0.05)。(3)老年T2DM合并NAFLD組患者的維生素D缺乏及維生素D不足發(fā)生的比例明顯高于老年T2DM不合并NAFLD組患者,差異具有統(tǒng)計學意義(P0.05)。(4)老年T2DM合并NAFLD組患者的25-OH-D3水平與年齡、FBG、HbAlc、2hPBG、TG、TC、LDL-C、HOMA-IR呈負相關(guān),差異均具有統(tǒng)計學意義(P0.05)。(5)多因素logistic回歸分析,結(jié)果顯示,BMI(OR=1.188,P0.05)、TG(OR=1.660,P0.05)、HOMA-IR(OR=1.660,P0.001)是老年T2DM患者NAFLD發(fā)生的危險因素,HDL-C、25-OH-D3則為老年T2DM患者NAFLD發(fā)生的保護因素。結(jié)論(1)老年T2DM合并NAFLD的患者較老年T2DM不合并NAFLD的患者具有更多的心、腦血管合并癥發(fā)病的危險因素,其發(fā)生心、腦血管系統(tǒng)并發(fā)癥的機率明顯升高。(2)老年T2DM合并NAFLD的患者較老年T2DM不合并NAFLD的患者25羥基維生素D3的水平明顯降低。25羥基維生素D3的缺乏會使非酒精性脂肪性肝病的患病率增加。探討25羥基維生素D3與非酒精性脂肪性肝病的關(guān)系,對提早發(fā)現(xiàn)心、腦血管并發(fā)癥,并及時進行干預和治療具有重要的臨床意義。
[Abstract]:Objective to investigate the changes in blood glucose, blood pressure, blood lipid, liver function, blood uric acid and 25-OH-D3 by observing the changes of blood glucose, blood pressure, blood lipid, liver function, blood uric acid and 25-OH-D3 in elderly type 2 diabetes mellitus (T2DM) patients with or without nonalcoholic fatty liver disease (NAFLD), and to explore the related factors of non-alcoholic fatty liver disease in elderly patients with type 2 diabetes and their relationship with 25-OH-D3. Methods 201 hospitalized patients in the Department of geriatrics and Department of endocrinology of First Hospital Affiliated to Lanzhou University from August 2015 to July 2016 were collected, aged at 60-87 years old, divided into aged T2DM (103 cases) or no (98 cases) NAFLD two groups. The age composition of the two groups was compared by ion chromatography high performance liquid, enzyme linked immunosorbent assay and B type superacoustic detection. Course of disease, common complication, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum uric acid (UA), triglyceride (TG), serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glycated hemoglobin (HbAlc), fasting blood glucose (FBG), fasting pancreas Isisin (FINS), fasting C peptide, 2 hour postprandial blood glucose (2hPBG), insulin resistance index (HOMA-IR), and 25 hydroxyvitamin D3 (25-OH-D3). Statistical analysis was carried out with SPSS18.0 software to explore the risk factors of NAFLD in elderly T2DM patients and the relationship with 25-OH-D3. Results (1) elderly T2DM combined with NAFLD group had hypertension and coronal heart. The risk of disease and carotid atherosclerosis was higher than that of the elderly T2DM without NAFLD group, and the difference was statistically significant (P0.05). (2) the elderly T2DM combined with NAFLD group had the course of diabetes, BMI, FINS, C peptide, UA, TC, TG, SBP, and the difference was statistically significant. The 25-OH-D3 level was lower than that of the elderly T2DM without NAFLD group, and the difference was statistically significant (P0.05). (3) the proportion of vitamin D deficiency and vitamin D deficiency in the elderly T2DM combined with NAFLD group was significantly higher than that in the elderly T2DM without NAFLD group, the difference was statistically significant (P0.05). (4) the elderly T2DM merged patients The 3 level was negatively correlated with age, FBG, HbAlc, 2hPBG, TG, TC, LDL-C, and HOMA-IR, and the difference was statistically significant (P0.05). (5) multiple factor Logistic regression analysis. The results showed that BMI (OR=1.188, P0.05) was the risk factor for the elderly patients. Conclusions (1) 1 patients with NAFLD in elderly patients with T2DM without NAFLD have more heart and risk factors for cerebrovascular complication, their incidence of cardiovascular system complications is significantly higher. (2) elderly T2DM with NAFLD in patients with older T2DM without NAFLD with 25 hydroxyl groups The level of.25 hydroxyl vitamin D3 is obviously reduced by the level of prime D3, which will increase the prevalence of nonalcoholic fatty liver disease. The study of the relationship between 25 hydroxyvitamin D3 and non-alcoholic fatty liver disease is of significant clinical significance for early detection of heart, cerebrovascular complications, and timely intervention and treatment.
【學位授予單位】：蘭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.1;R575
本文編號：2150445
[Abstract]:Objective to investigate the changes in blood glucose, blood pressure, blood lipid, liver function, blood uric acid and 25-OH-D3 by observing the changes of blood glucose, blood pressure, blood lipid, liver function, blood uric acid and 25-OH-D3 in elderly type 2 diabetes mellitus (T2DM) patients with or without nonalcoholic fatty liver disease (NAFLD), and to explore the related factors of non-alcoholic fatty liver disease in elderly patients with type 2 diabetes and their relationship with 25-OH-D3. Methods 201 hospitalized patients in the Department of geriatrics and Department of endocrinology of First Hospital Affiliated to Lanzhou University from August 2015 to July 2016 were collected, aged at 60-87 years old, divided into aged T2DM (103 cases) or no (98 cases) NAFLD two groups. The age composition of the two groups was compared by ion chromatography high performance liquid, enzyme linked immunosorbent assay and B type superacoustic detection. Course of disease, common complication, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum uric acid (UA), triglyceride (TG), serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glycated hemoglobin (HbAlc), fasting blood glucose (FBG), fasting pancreas Isisin (FINS), fasting C peptide, 2 hour postprandial blood glucose (2hPBG), insulin resistance index (HOMA-IR), and 25 hydroxyvitamin D3 (25-OH-D3). Statistical analysis was carried out with SPSS18.0 software to explore the risk factors of NAFLD in elderly T2DM patients and the relationship with 25-OH-D3. Results (1) elderly T2DM combined with NAFLD group had hypertension and coronal heart. The risk of disease and carotid atherosclerosis was higher than that of the elderly T2DM without NAFLD group, and the difference was statistically significant (P0.05). (2) the elderly T2DM combined with NAFLD group had the course of diabetes, BMI, FINS, C peptide, UA, TC, TG, SBP, and the difference was statistically significant. The 25-OH-D3 level was lower than that of the elderly T2DM without NAFLD group, and the difference was statistically significant (P0.05). (3) the proportion of vitamin D deficiency and vitamin D deficiency in the elderly T2DM combined with NAFLD group was significantly higher than that in the elderly T2DM without NAFLD group, the difference was statistically significant (P0.05). (4) the elderly T2DM merged patients The 3 level was negatively correlated with age, FBG, HbAlc, 2hPBG, TG, TC, LDL-C, and HOMA-IR, and the difference was statistically significant (P0.05). (5) multiple factor Logistic regression analysis. The results showed that BMI (OR=1.188, P0.05) was the risk factor for the elderly patients. Conclusions (1) 1 patients with NAFLD in elderly patients with T2DM without NAFLD have more heart and risk factors for cerebrovascular complication, their incidence of cardiovascular system complications is significantly higher. (2) elderly T2DM with NAFLD in patients with older T2DM without NAFLD with 25 hydroxyl groups The level of.25 hydroxyl vitamin D3 is obviously reduced by the level of prime D3, which will increase the prevalence of nonalcoholic fatty liver disease. The study of the relationship between 25 hydroxyvitamin D3 and non-alcoholic fatty liver disease is of significant clinical significance for early detection of heart, cerebrovascular complications, and timely intervention and treatment.
【學位授予單位】：蘭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.1;R575
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