TyG指数与2型糖尿病患者非酒精性脂肪肝相关性研究
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摘要
目的探讨TyG指数与2型糖尿病患者非酒精性脂肪肝相关性。方法选取2015年1月～2018年3月于我院诊治的2型糖尿病患者214例,根据是否合并非酒精性脂肪肝分为观察组(2型糖尿病合并非酒精性脂肪肝),对照组(2型糖尿病)。观察组133例,对照组81例。统计所有患者年龄、性别、BMI、收缩压、舒张压、糖尿病病程、空腹静脉血,检测空腹血糖(FPG)、低密度胆固醇(LDL-C)、高密度胆固醇(HDL-C)、总胆固醇(TC)及三酰甘油(TG)、糖化血红蛋白(HbA1C),并计算TyG指数。通过Pearson相关性分析FPG、LDL-C、HDL-C、TG、TC与TyG指数的相关性。通过受试者工作特征曲线(ROC)对TyG指数诊断2型糖尿病并非酒精性脂肪肝的诊断效能进行分析。结果两组一般资料包括年龄、性别、糖尿病病程、FPG及HbA1C差异无统计学意义(P> 0.05);观察组的BMI、收缩压、舒张压、LDL-C、TC、TG及TyG指数均较对照组高,差异均有统计学意义(P <0.05);而观察组的HDL-C显著低于对照组,差异有统计学意义(P <0.05)。Pearson相关性分析显示,FPG、LDL-C、TG、TC均与TyG指数呈正相关(r值分别为:0.648、0.164、0.796、0.156,P <0.05)。受试者工作特征曲线(ROC)对TyG指数诊断2型糖尿病并非酒精性脂肪肝的诊断效能分析显示,TyG指数可用于辅助诊断2型糖尿病并非酒精性脂肪肝,最高AUC为0.844,当临界值取4.86时,TyG诊断2型糖尿病并非酒精性脂肪肝的敏感性、特异性分别为87.7%、71.4%。结论 TyG指数与2型糖尿病患者非酒精性脂肪肝密切相关;FPG、LDL-C、TG、TC均与TyG指数呈正相关;高TyG指数可用于2型糖尿病并非酒精性脂肪肝的辅助诊断及评估患者病情。
Objective To explore the correlation between TyG index and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus. Methods 214 patients with type 2 diabetes mellitus who were diagnosed in our hospital from January 2015 to March 2018 were selected.Patients were divided into the observation group(type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease) and the control group(type 2 diabetes mellitus) according to whether they were complicated with nonalcoholic fatty liver disease.There were 133 cases in the observation group and 81 cases in the control group.The age,gender,BMI,systolic blood pressure,diastolic blood pressure,diabetes course,fasting venous blood of all the patients were counted.Fasting blood glucose(FPG),low-density cholesterol(LDL-C),high-density cholesterol(HDL-C),total cholesterol(TC),triglyceride(TG) and glycosylated hemoglobin(HbA1 C) were detected and TyG index was calculated.Pearson correlation was used to analyze the correlation between FPG,LDL-C,HDL-C,TG,TC and TyG index.The diagnostic efficacy of TyG index in the diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease was analyzed by receiver operating characteristic curve(ROC). Results There was no statistical difference in basic data between the two groups,including age,gender,diabetes course,FPG and HbA1 C(P > 0.05).BMI,systolic blood pressure,diastolic blood pressure,LDL-C,TC,TG and TyG index of the observation group were all higher than those of the control group and the differences were statistically significant(P < 0.05).But the HDL-C of the observation group was significantly lower than that of the control group.The difference was statistically significant(P < 0.05).Pearson correlation analysis showed that FPG,LDL-C,TG and TC were positively correlated with TyG index(The r values were 0.648,0.164,0.796 and 0.156, respectively,P < 0.05).Diagnostic efficacy of TyG index in the diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease analyzed by receiver operating characteristic curve(ROC) showed that TyG index could be used in the auxiliary diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease,and the highest AUC was 0.844.When the critical value was 4.86,the sensitivity and specificity of TyG in the diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease were 87.7% and 71.4%,respectively. Conclusion TyG index is closely related to patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease.FPG,LDL-C,TG and TC are all positively correlated with TyG index.High TyG index can be used for the auxiliary diagnosis and assessment of patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease.
Objective To explore the correlation between TyG index and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus. Methods 214 patients with type 2 diabetes mellitus who were diagnosed in our hospital from January 2015 to March 2018 were selected.Patients were divided into the observation group(type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease) and the control group(type 2 diabetes mellitus) according to whether they were complicated with nonalcoholic fatty liver disease.There were 133 cases in the observation group and 81 cases in the control group.The age,gender,BMI,systolic blood pressure,diastolic blood pressure,diabetes course,fasting venous blood of all the patients were counted.Fasting blood glucose(FPG),low-density cholesterol(LDL-C),high-density cholesterol(HDL-C),total cholesterol(TC),triglyceride(TG) and glycosylated hemoglobin(HbA1 C) were detected and TyG index was calculated.Pearson correlation was used to analyze the correlation between FPG,LDL-C,HDL-C,TG,TC and TyG index.The diagnostic efficacy of TyG index in the diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease was analyzed by receiver operating characteristic curve(ROC). Results There was no statistical difference in basic data between the two groups,including age,gender,diabetes course,FPG and HbA1 C(P > 0.05).BMI,systolic blood pressure,diastolic blood pressure,LDL-C,TC,TG and TyG index of the observation group were all higher than those of the control group and the differences were statistically significant(P < 0.05).But the HDL-C of the observation group was significantly lower than that of the control group.The difference was statistically significant(P < 0.05).Pearson correlation analysis showed that FPG,LDL-C,TG and TC were positively correlated with TyG index(The r values were 0.648,0.164,0.796 and 0.156, respectively,P < 0.05).Diagnostic efficacy of TyG index in the diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease analyzed by receiver operating characteristic curve(ROC) showed that TyG index could be used in the auxiliary diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease,and the highest AUC was 0.844.When the critical value was 4.86,the sensitivity and specificity of TyG in the diagnosis of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease were 87.7% and 71.4%,respectively. Conclusion TyG index is closely related to patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease.FPG,LDL-C,TG and TC are all positively correlated with TyG index.High TyG index can be used for the auxiliary diagnosis and assessment of patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease.
引文
[1]邱俊霖,钟宇华,曾云先,等.以糖尿病酮症酸中毒起病的暴发性1型糖尿病患者流行病学特点临床分析[J].临床内科杂志,2016,33(2):99-100.
[2]Kirpich IA,Marsano LS,Mcclain CJ.Gut-Liver Axis,Nutrition,and Non Alcoholic Fatty Liver Disease[J].ClinBiochem,2015,48(13-14):923-930.
[3]李彦平,窦春彦,王昆,等.2型糖尿病男性患者性激素结合球蛋白与非酒精性脂肪肝的相关性[J].山西医科大学学报,2018,49(3):269-272.
[4]刘阳,于世家,文涛.2型糖尿病合并非酒精性脂肪肝相关影响因素分析[J].中国公共卫生,2018,34(9):1-3.
[5]Tokita Y,Maejima Y,Shimomura K,et al.Non-alcoholic Fatty Liver Disease Is a Risk Factor for Type 2 Diabetes in Middle-aged Japanese Men and Women[J].Intern Med,2017,56(7):763-771.
[6]Brenner C,Galluzzi L,Kepp O,et al.Decoding cell death signals in liver inflammation[J].J Hepatol,2013,59(3):583-594.
[7]Bouchi R,Takeuchi T,Akihisa M,et al.Increased visceral adiposity with normal weight is associated with the prevalence of non-alcoholic fatty liver disease in Japanese patients with type 2 diabetes[J].J Diabetes Investig,2016,7(4):607-614.
[8]陈素琴,黎明江,吴限,等.TyG指数与2型糖尿病患者冠状动脉病变相关性研究[J].疑难病杂志,2017,16(8):761-764.
[9]邓子玄,周健,贾伟平.2014年美国糖尿病学会糖尿病医学诊治标准更新内容解读[J].中国医学前沿杂志(电子版),2014,6(1):66-73.
[10]阎劲松,袁丹,李东升.影响2型糖尿病患者新发非酒精性脂肪肝相关因素分析[J].实用肝脏病杂志,2016,19(2):212-214.
[11]张喜婷,胡玲,王宁,等.2型糖尿病并发非酒精性脂肪肝的危险因素及其与糖尿病大血管病变的相关性研究[J].中国全科医学,2012,15(12):1332-1334.
[12]罗红.2型糖尿病与非糖尿病患者非酒精性脂肪肝发病情况的临床分析.临床军医杂志,2013,41(4):345-346.
[13]李朝喜,刘杨,史丽,等.T2DM并发非酒精性脂肪肝老年患者和动脉粥样硬化的关系及其相关影响因素研究.重庆医学,2015,44(17):2414-2416.
[14]苏锦良.非酒精性脂肪肝患者血脂、血糖及肝功能的检验价值[J].齐齐哈尔医学院学报,2017,38(2):166-167.
[15]徐建华,石群,顾红霞,等.2型糖尿病与非酒精性脂肪肝相关性研究[J].中华全科医学,2014,12(7):1082-1083.
[16]阎劲松,袁丹,李东升.影响2型糖尿病患者新发非酒精性脂肪肝相关因素分析[J].实用肝脏病杂志,2016,19(2):212-214.
[17]刘宗英.非酒精性脂肪肝患者肝功能酶学指标与血脂检测结果相关分析[J].中国肝脏病杂志(电子版),2014,6(2):50-52.
[18]杨瑞,甘建骏,李立,等.冠心病患者Ty G index与TNF-α、IL-6的相关性研究[J].中外医疗,2015,3(3):67-68.
[2]Kirpich IA,Marsano LS,Mcclain CJ.Gut-Liver Axis,Nutrition,and Non Alcoholic Fatty Liver Disease[J].ClinBiochem,2015,48(13-14):923-930.
[3]李彦平,窦春彦,王昆,等.2型糖尿病男性患者性激素结合球蛋白与非酒精性脂肪肝的相关性[J].山西医科大学学报,2018,49(3):269-272.
[4]刘阳,于世家,文涛.2型糖尿病合并非酒精性脂肪肝相关影响因素分析[J].中国公共卫生,2018,34(9):1-3.
[5]Tokita Y,Maejima Y,Shimomura K,et al.Non-alcoholic Fatty Liver Disease Is a Risk Factor for Type 2 Diabetes in Middle-aged Japanese Men and Women[J].Intern Med,2017,56(7):763-771.
[6]Brenner C,Galluzzi L,Kepp O,et al.Decoding cell death signals in liver inflammation[J].J Hepatol,2013,59(3):583-594.
[7]Bouchi R,Takeuchi T,Akihisa M,et al.Increased visceral adiposity with normal weight is associated with the prevalence of non-alcoholic fatty liver disease in Japanese patients with type 2 diabetes[J].J Diabetes Investig,2016,7(4):607-614.
[8]陈素琴,黎明江,吴限,等.TyG指数与2型糖尿病患者冠状动脉病变相关性研究[J].疑难病杂志,2017,16(8):761-764.
[9]邓子玄,周健,贾伟平.2014年美国糖尿病学会糖尿病医学诊治标准更新内容解读[J].中国医学前沿杂志(电子版),2014,6(1):66-73.
[10]阎劲松,袁丹,李东升.影响2型糖尿病患者新发非酒精性脂肪肝相关因素分析[J].实用肝脏病杂志,2016,19(2):212-214.
[11]张喜婷,胡玲,王宁,等.2型糖尿病并发非酒精性脂肪肝的危险因素及其与糖尿病大血管病变的相关性研究[J].中国全科医学,2012,15(12):1332-1334.
[12]罗红.2型糖尿病与非糖尿病患者非酒精性脂肪肝发病情况的临床分析.临床军医杂志,2013,41(4):345-346.
[13]李朝喜,刘杨,史丽,等.T2DM并发非酒精性脂肪肝老年患者和动脉粥样硬化的关系及其相关影响因素研究.重庆医学,2015,44(17):2414-2416.
[14]苏锦良.非酒精性脂肪肝患者血脂、血糖及肝功能的检验价值[J].齐齐哈尔医学院学报,2017,38(2):166-167.
[15]徐建华,石群,顾红霞,等.2型糖尿病与非酒精性脂肪肝相关性研究[J].中华全科医学,2014,12(7):1082-1083.
[16]阎劲松,袁丹,李东升.影响2型糖尿病患者新发非酒精性脂肪肝相关因素分析[J].实用肝脏病杂志,2016,19(2):212-214.
[17]刘宗英.非酒精性脂肪肝患者肝功能酶学指标与血脂检测结果相关分析[J].中国肝脏病杂志(电子版),2014,6(2):50-52.
[18]杨瑞,甘建骏,李立,等.冠心病患者Ty G index与TNF-α、IL-6的相关性研究[J].中外医疗,2015,3(3):67-68.
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