| 摘要: |
| 目的:应用超声技术评价2型糖尿病(T2DM) 患者合并非酒精性脂肪肝（NAFLD）与心外膜脂肪组织（EAT）厚度的相关关系。
方法:选取2017年12月至2018年7月在大连医科大学附属第二医院内分泌科住院且合并NAFLD的T2DM患者50例作为NAFLD组，另选取47例不合并NAFLD的T2DM患者作为对照组（A组）。对2组患者行肝脏超声及经胸超声心动图检查，根据肝脏超声二维图像特征将NAFLD组按照脂肪肝严重程度分为轻度（B组）、中度（C组）及重度（D组），并测量四组EAT厚度进行相关性分析。同时获得血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后2h血糖(2hPG)、体质指数(BMI)、腰围等临床及生化指标。
结果: B、C、D组的EAT值均高于A组 (P均<0.05),C、D组均高于B组(P均<0.05)，D组高于C组(P<0.05)。Spearman相关分析中提示EAT与NAFLD严重程度（r=0.782, P<0.001）、HbA1c（r=0.679, P<0.001）、TG（r =0.649, P<0.001）、BMI（r=0.601，P<0.05）及腰围（r=0.564，P<0.05）呈正相关。在多重线性回归分析中HbAlc、TG、BMI是EAT的独立预测因子。
结论: T2DM患者合并NAFLD时，其EAT厚度明显增厚，且EAT随着NAFLD严重程度的增加而增加，二者呈正相关关系，因此超声技术可以客观地评价T2DM合并NAFLD患者EAT的异常改变，具有重要的临床意义。 |
| 关键词: 心外膜脂肪组织 非酒精性脂肪肝 糖尿病 2型 超声 |
| DOI： |
| 投稿时间：2019-03-01修订日期：2019-03-30 |
| 基金项目: |
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| Evaluation of correlation of Nonalcoholic Fatty Liver and Epicardial Fat Thickness in Patients with Type 2 Diabetes Mellitus by ultrasonography |
| yangyue,zhang yuhong |
| () |
| Abstract: |
| Abstract: Objective To investigate the correlation between non-alcoholic fatty liver disease (NAFLD) and epicardial fat thickness (EAT) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 50 cases of T2DM with NAFLD were selected from December 2017 to July 2018 in the Second Affiliated Hospital of Dalian Medical University. And 47 cases of T2DM without NAFLD were selected as the control group（group A）. Ultrasonography and transthoracic echocardiography were performed in the two groups. NAFLD participants were further divided into mild（group B）, moderate（group C） and severe（group D） according to the 2-dimensional ultrasonography. EAT were obtained at the same time and the correlation was analyzed. Total cholesteroi(TC), triglyceride(TG), low-density lipoprotein(LDL), high-density lipoprotein(HDL), glycosylated hemoglobin Alc (HbA1c), fasting plasma glucose(FBG), 2h postprandial glycemia (2hPG), body mass index(BMI), and waist circumference were measured．Results The EAT values of group B, C and D were higher than those of group A (P<0.05). Groups C and D were higher than group B (P<0.05), and group D was higher than group C (P<0.05). Spearman correlation analysis indicated EAT and NAFLD severity (r=0.782, P<0.001), HbA1c (r=0.679, P<0.001), TG (r=0.649, P<0.001), BMI(r=0.601, P< 0.05) and waist circumference (r = 0.564, P < 0.05) showed a positive correlation. HbAlc, TG and BMI were independent predictors of EAT in multiple linear regression analysis. Conclusions When T2DM patients with NAFLD, their EAT thickness is significantly thickened, and EAT increases with the severity of NAFLD. There is a positive correlation between them. Therefore, ultrasound technology can objectively evaluate the abnormal changes of EAT in T2DM patients with NAFLD with clinical significance. |
| Key words: Epicardial fat thickness Nonalcoholic fatty liver Diabetes mellitus, Type 2 Ultrasound |
