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2型糖尿病合并非酒精性脂肪性肝病患者肝纤维化与血尿酸水平的关系
Association between liver fibrosis and serum uric acid in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease
文章发布日期:2020年06月01日  来源:  作者:刘婷,王臣廷,刘美晓,等  点击次数:187次  下载次数:42次

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【摘要】:目的 探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者肝纤维化与血尿酸水平的关系。方法 选取2018年1月-2019年8月在沧州市人民医院就诊的T2DM合并NAFLD患者328例,应用NAFLD纤维化评分(NFS)联合FIB-4评估肝纤维化风险,分为肝纤维化低危组(136例)、肝纤维化中危组(145例)及肝纤维化高危组(47例);另选取资料匹配的T2DM患者141例为对照。比较各组血尿酸水平的差异。计量资料多组间比较采用单因素方差分析或Kruskal-Wallis H检验;计数资料组间比较采用χ2检验。采用logistic回归法分析肝纤维化的影响因素。绘制受试者工作曲线(ROC)评价危险因素的预测效能。结果 与T2DM组相比,T2DM合并NAFLD组血尿酸水平显著升高,差异有统计学意义(265.00±77.01 vs 313.04±100.90,t=-5.619,P<0.001)。与肝纤维化低危组(290.70±95.46)和中危组(328.15±90.85)相比,肝纤维化高危组患者(392.77±108.37)血尿酸水平显著升高(P值均<0.01)。肝纤维化高危组高尿酸血症患病率亦显著高于肝纤维化低危组和中危组(47.00% vs 11.72% vs 11.76%,P值均<0.01)。logistic回归分析显示血尿酸[比值比=1.133,95%可信区间: 1.064~1.312]是T2DM合并NAFLD患者发生肝纤维化的独立危险因素。ROC曲线显示血尿酸对肝纤维化有一定预测价值,ROC曲线下面积为0.745。结论 高血尿酸水平是T2DM合并NAFLD患者肝纤维化发生发展的独立危险因素。
【Abstract】:Objective To investigate the association between liver fibrosis and serum uric acid in patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD). Methods A total of 328 patients with T2DM and NAFLD who attended Cangzhou People’s Hospital from January 2018 to August 2019 were enrolled, and according to NAFLD fibrosis score (NFS) and fibrosis-4 (FIB-4) index, they were divided into low-risk fibrosis group with 136 patients, intermediate-risk fibrosis group with 145 patients, and high-risk fibrosis group with 47 patients. A total of 141 patients with T2DM, matched for age and sex, were enrolled as T2DM group. Serum uric acid was compared between groups. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups, and the chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used to determine the influencing factors for liver fibrosis, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiencies of risk factors. Results Compared with the T2DM group, the T2DM+NAFLD group had a significant increase in serum uric acid (313.04±100.90 vs 265.00±77.01, t=-5.619, P<0.001). The high-risk fibrosis group had a significant increase in serum uric acid compared with the low-risk fibrosis group (392.77±108.37 vs 290.70±95.46, P<0.05) and the intermediate-risk fibrosis group (392.77±108.37 vs 328.15±90.85, P<0.05), and the high-risk fibrosis group had a significantly higher prevalence rate of hyperuricemia than the low-risk fibrosis group and the intermediate-risk fibrosis group (47.00% vs 11.72% vs 11.76%, P<0.01). The logistic regression analysis showed that serum uric acid (odds ratio=1.133, 95% confidence interval: 1.064-1.312) was an independent risk factor for liver fibrosis in patients with T2DM and NAFLD. The ROC curve showed that serum uric acid had a certain value in predicting liver fibrosis, with an area under the ROC curve of 0.745. Conclusion The high level of serum uric acid is an independent risk factor for the development and progression of liver fibrosis in patients with T2DM and NAFLD.
【关键字】:糖尿病,2型; 非酒精性脂肪性肝病; 肝硬化; 血尿酸
【Key words】:diabetes mellitus,type 2; nonalcoholic fatty liver disease; liver cirrhosis; uric acid
【引证本文】:LIU T, WANG CT, LIU MX, et al. Association between liver fibrosis and serum uric acid in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2020, 36(6): 1320-1324. (in Chinese)
刘婷, 王臣廷, 刘美晓, 等. 2型糖尿病合并非酒精性脂肪性肝病患者肝纤维化与血尿酸水平的关系[J]. 临床肝胆病杂志, 2020, 36(6): 1320-1324.

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