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

刘婷; 王臣廷; 刘美晓; 刘建凤; 郑少雄

doi:10.3969/j.issn.1001-5256.2020.06.026

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

DOI: 10.3969/j.issn.1001-5256.2020.06.026

1. 承德医学院研究生学院
2. 承德医学院附属沧州市人民医院内分泌代谢科
3. 沧州医学高等专科学校解剖教研室
4. 天津医科大学第二医院内分泌科

基金项目:

河北省教育厅在读研究生创新能力培养资助项目(CXZZSS2020132)；

详细信息

中图分类号: R575.5;R587.1
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出版历程
- 出版日期: 2020-06-20

Association between liver fibrosis and serum uric acid in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease

Research funding:

摘要

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...
- 糖尿病,2型 /
- 非酒精性脂肪性肝病 /
- 肝硬化 /
- 血尿酸
Abstract:
Objective To investigate the association between liver fibrosis and serum uric acid in patients with type 2 diabetes mellitus( T2 DM) and nonalcoholic fatty liver disease( NAFLD). Methods A total of 328 patients with T2 DM 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 T2 DM,matched for age and sex,were enrolled as T2 DM 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 T2 DM group,the T2 DM + 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 T2 DM 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 T2 DM and NAFLD.
- diabetes mellitus,type 2 /
- nonalcoholic fatty liver disease /
- liver cirrhosis /
- uric acid

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