2型糖尿病合并非酒精性脂肪肝58例

Diagnostic value of trans-abdominal ultrasonography in diabetes mellitus complicated with nonalcoholic steatohepatitis and risk factors for nonalcoholic steatohepatitis

AIM: To assess the diagnostic value of trans-abdominal ultrasonography in type 2 diabetes mellitus (T2DM) complicated with nonalcoholic steatohepatitis (NASH), and to analyze the risk factors for NASH.

METHODS: From January 2013 to December 2015, 200 patients with T2DM were divided into three groups according to the results of ultrasonography and pathological examinations: 94 patients in a non-hepatic lesion group, 62 patients in a simple fatty liver group, and 44 patients in an NASH group. Clinical data, blood biochemical and liver function indexes were compared among the three groups. The results of quantitative ultrasonography were compared between the simple fatty liver group and NASH group. Risk factors for NASH were analyzed.

RESULTS: BMI, WHR, FPG, HbA1c, blood lipid and liver function indexes had significant differences among the three groups (P < 0.05). Quantitative ultrasonography showed that in the simple liver fatty liver group, 37 (59.68%) cases were mild, 15 (24.19%) were moderate and 10 (16.13%) were serious; in the NASH group, the corresponding figures were 4 (9.09%), 22 (50.00%) and 18 (40.91%), respectively. There were significant differences between the two groups (P < 0.05). The result of quantitative ultrasonography had a significant correlation with G (r = 0.763, P < 0.05) and S (r = 0.375, P < 0.05), but not with F (r = 0.177, P > 0.05). NASH was significantly related to duration of DM, BMI, WHR, blood lipid and results of quantitative ultrasonography (P < 0.05).

CONCLUSION: Trans-abdominal ultrasonography has value in the screening of T2DM complicated with NASH, and trans-abdominal ultrasonography in combination with evaluation of risk factors can increase the diagnostic accuracy.

Risk factors for non-alcoholic fatty liver disease combined with type 2 diabetes mellitus in adolescents

AIM: To investigate the risk factors for non-alcoholic fatty liver disease (NAFLD) combined with type 2 diabetes mellitus (T2DM) in adolescents.

METHODS: A long-term follow-up study of 721 urban adolescents showed that there were 134 NAFLD cases and 17 cases of T2DM. Twelve NAFLD patients had combined T2DM. The risk factors for NAFLD combined with T2DM were analyzed using univariate and multivariate logistic regression analyses.

RESULTS: The NAFLD prevalence rate in urban adolescents was 18.6%. The prevalence rate in males was significantly higher than that in females (P < 0.05). The percentage of patients with a fatty liver family history, body mass index (BMI), waist-hip ratio (WHR), ratio of intra-abdominal obesity, 2 h postprandial blood glucose (2 h PBG) and rate of T2DM in NAFLD patients were significantly higher than those in non-NAFLD patients (P < 0.05). BMI, WHR, severity of fatty liver, fasting blood glucose (FBG), aspartate aminotransferase (AST), gamma glutamine transferase (γ-GT), total cholesterol (TC), and the percentages of patients with diabetes family history or fatty liver family history in NAFLD patients with T2DM were significantly higher than those in NAFLD patients without T2DM (P < 0.05). Univariate logistic regression analysis showed that age, BMI ≥ 28 kg/m², intra-abdominal obesity, fatty liver family history and diabetes family history were significantly related to NAFLD combined with T2DM. In the following multivariate logistic regression, only BMI ≥ 28 kg/m² and diabetes family history were significantly related to NAFLD combined with T2DM in adolescents.

CONCLUSION: The rate of T2DM in NAFLD adolescents is significantly higher than that in non-NAFLD adolescents. Obesity (BMI ≥ 28 kg/m²) and diabetes family history are risk factors for NAFLD combined with T2DM in adolescents. Controlling weight effectively is urgent to NAFLD patients with a diabetes family history in adolescents.