|
摘要：
|
|
摘要：目的 探讨长期应用他汀类药物对2型糖尿病（diabetes mellitus type 2，T2DM）
患者发生进展期肝纤维化、肝硬化和代谢相关脂肪性肝病（metabolic associated fatty
liver disease，MAFLD）的影响。方法 以2019年4月至2023年9月在青海省第四人民医
院就诊的819例T2DM患者为研究对象。收集患者的人口学、并发症、实验室检查、
药物应用史及生活方式等资料，应用多因素Logisitic回归分析T2DM患者发生进展期肝纤
维化、肝硬化、MAFLD的影响因素。 结果 多因素Logisitic回归分析表明，年龄≥ 60岁
（OR = 1.217，95%CI：1.114～1.329，P ＜ 0.001）、体重指数（body mass index，
BMI）≥ 25 kg/m2（OR = 1.657，95%CI：1.203～2.282，P = 0.001）、γ-谷氨酰转移酶
（gamma-glutamyltransferase，GGT）＞ 50 U/L（OR = 1.792，95%CI：1.175～2.732，
P = 0.006）、空腹血糖（fasting plasma glucose，FPG）＞ 6.1 mmol/L（OR = 1.367，
95%CI：1.141～1.637，P ＜ 0.001）、饮酒（OR = 1.904，95%CI：1.468～2.469，
P ＜ 0.001）是T2DM患者发生进展期肝纤维化的危险因素，应用他汀类药物是保护因
素（OR = 0.407，95%CI：0.234～0.707，P = 0.001）。男性（OR = 1.893，95%CI：
1.344～2.665，P ＜ 0.001）、肝癌家族史（OR = 2.416，95%CI：1.503～3.882，P ＜
0.001）、GGT ＞ 50 U/L（OR = 1.552，95%CI：1.138～2.118，P = 0.005）、FPG ＞
6.1 mmol/L（OR = 1.405，95%CI：1.073～1.839，P = 0.013）、饮酒（OR = 1.893，
95%CI：1.353～2.647，P ＜ 0.001）是T2DM患者发生肝硬化的危险因素，应用他汀
类药物为保护因素（OR = 0.829，95%CI：0.704～0.976，P = 0.024）。男性（OR =
2.015，95%CI：1.369～2.967，P ＜ 0.001）、BMI ≥ 25 kg/m2（OR = 1.872，95%CI：
1.394～2.514，P ＜ 0.001）、高脂血症（OR = 1.993，95%CI：1.387～2.865，P ＜
0.001）、胰岛素抵抗指数（homeostasis model assessment of insulin resistance，HOMAIR）＞
3%（OR = 1.243，95%CI：1.060～1.458，P = 0.007）是T2DM患者发生MAFLD
的危险因素，规范胰岛素治疗是保护因素（OR = 0.592，95%CI：0.441～0.795，P ＜
0.001）。结论 他汀类药物可降低T2DM患者进展期肝纤维化和肝硬化的发生率，对
MAFLD发生率无明显影响。
|
|
Abstract: Objective To investigate the effects of long-term statin use on progressive liver
fibrosis, liver cirrhosis and metabolic associated fatty liver disease (MAFLD) in patients
with type 2 diabetes (T2DM). Methods Total of 819 patients with T2DM in The Fourth
People’s Hospital of Qinghai Province from April 2019 to September 2023 were selected.
Demographic, comorbidities, laboratory indicators, medication history and lifestyle of patients
were collected. Multivariate Logisitic regression analysis was used to analyze the influence
factors affecting the prevalence of progressive liver fibrosis, liver cirrhosis and MAFLD in
patients with T2DM. Results Multivariate Logisitic regression analysis showed that age ≥
60 years (OR = 1.217, 95%CI: 1.114～1.329, P ＜ 0.001), body mass index (BMI) ≥ 25 kg/m2
(OR = 1.657, 95%CI: 1.203～2.282, P = 0.001), gamma-glutamyltransferase (GGT) ＞ 50 U/L (OR =
1.792, 95%CI: 1.175～2.732, P = 0.006), fasting plasma glucose (FPG) ＞ 6.1 mmol/L (OR =
1.367, 95%CI: 1.141～1.637, P ＜ 0.001) and drinking (OR = 1.904, 95%CI: 1.468～2.469,
P ＜ 0.001) were the risk factors for progressive liver fibrosis in patients with T2DM, statins
was a protective factor (OR = 0.407, 95%CI: 0.234～0.707, P = 0.001). Male (OR = 1.893,
95%CI: 1.344～2.665, P ＜ 0.001), family history of liver cancer (OR = 2.416, 95%CI:
1.503～3.882, P ＜ 0.001), GGT ＞ 50 U/L（OR = 1.552, 95%CI: 1.138～2.118, P = 0.005）,
FPG ＞ 6.1 mmol/L（OR = 1.405, 95%CI: 1.073～1.839, P = 0.013）and drinking (OR =
1.893, 95%CI: 1.353～2.647, P ＜ 0.001) were the risk factors for liver cirrhosis in patients
with T2DM, statins was a protective factor (OR = 0.829, 95%CI：0.704～0.976, P = 0.024).
Male (OR = 2.015, 95%CI: 1.369～2.967, P ＜ 0.001), BMI ≥ 25 kg/m2 (OR = 1.872,
95%CI: 1.394～2.514, P ＜ 0.001), hyperlipidemia (OR = 1.993, 95%CI: 1.387～2.865,
P ＜ 0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) ＞ 3%
(OR = 1.243, 95%CI: 1.060～1.458, P = 0.007) were risk factors for MAFLD in patients
with T2DM, standardized insulin therapy was a protective factor (OR = 0.592, 95%CI:
0.441～0.795, P ＜ 0.001). Conclusions Statins can reduce the prevalence of progressive liver
fibrosis and cirrhosis in T2DM patients, but there was no significant effect on the incidence of
MASLD.
|
|
基金项目：
|
|
|
|
作者简介：
|
|
|
|
参考文献：
|
|
|
|
服务与反馈：
|
|
【文章下载】【加入收藏】
|
|
|
|