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目的探讨甘油三酯(TG)水平对2型糖尿病患者发生非酒精性脂肪肝(NAFLD)风险的预测价值。方法此研究为前瞻性队列研究,对象来自2006-2007年度河北唐山开滦集团公司员工健康查体数据库,选取符合2型糖尿病诊断标准的研究对象作为观察队列,共9 489人,于2008-2009年度进行第二次体检,纳入最终统计分析的有效数据为2 937例(男性2 460例,女性477例)。用甘油三酯(TG)作为发生NAFLD的一个预测指标,比较不同基线TG水平2型糖尿病患者2008-2009年度进行第二次体检时NAFLD的发病率。用Logistic回归分析基线TG水平对2型糖尿病患者发生NAFLD风险的预测价值。结果 12年间观察队列中有850例发生NAFLD,发生NAFLD的比例为28.9%。2按2006-2007年TG水平四分位分组如下:<0.96mmol/L,0.96mmol/L≤TG<1.34mmol/L,1.34mmol/L≤TG<2.01mmol/L和TG≥2.01mmol/L,2年后NAFLD的发病率随TG基线水平的增加而增加(分别为17.7%、27.0%、31.9%和39.5%,P<0.01)。3TG最高四分位组(TG≥2.01mmol/L)发生NAFLD的风险是最低四分位组(TG<0.96mmol/L)的3.03倍(95%CI:2.39~3.85,P<0.01)。用多因素Logistic回归分析校正年龄、性别、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸、空腹血糖、BMI后,最高四分位数组发生NAFLD的风险仍是最低四分位数组的3.07倍(95%CI:2.41~3.90,P<0.01)。结论基线甘油三酯水平对2型糖尿病患者发生NAFLD的风险有一定的预测价值,甘油三酯水平较高者发生NAFLD的风险增加。
Objective To investigate the predictive value of triglyceride (TG) in the risk of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetic patients. Methods This study was a prospective cohort study. The subjects were from the database of employee health checkups of Kailuan Group Corporation, Tangshan, Hebei Province, 2006-2007. A total of 9 489 study subjects were selected according to the diagnostic criteria of type 2 diabetes mellitus. During 2008-2009 For the second annual physical examination, there were 2 937 valid examples (2460 males and 477 females) for inclusion in the final statistical analysis. Triglyceride (TG) was used as a predictor of NAFLD to compare the incidence of NAFLD at the second physical examination in patients with type 2 diabetes mellitus at different baseline TG levels during the 2008-2009 period. Logistic regression was used to analyze the predictive value of baseline TG level for the risk of NAFLD in type 2 diabetic patients. Results During the 12 years, there were 850 cases of NAFLD in the observation cohort and 28.9% of the patients had NAFLD. 2 were grouped by quartiles of TG levels from 2006 to 2007 as follows: <0.96 mmol / L, 0.96 mmol / L≤TG <1.34 mmol / L, 1.34 mmol / L≤TG <2.01 mmol / L and TG≥2.01 mmol / L After 2 years, the incidence of NAFLD increased with the increase of baseline TG level (17.7%, 27.0%, 31.9% and 39.5% respectively, P <0.01). The risk of NAFLD in the highest tertile of 3TG (TG≥2.01mmol / L) was 3.03 times (95% CI: 2.39-3.85, P <0.01) in the lowest quartile (TG <0.96mmol / L). After adjusting for age, sex, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum uric acid, fasting blood glucose, and BMI by multivariate logistic regression analysis, the highest quartile of NAFLD remained the lowest quartile 3.07 folds of the array (95% CI: 2.41-3.90, P <0.01). Conclusions Baseline triglyceride levels have some predictive value for the risk of developing NAFLD in patients with type 2 diabetes. The higher the risk of NAFLD, the higher the level of triglycerides.