肌肉脂肪比值在2型糖尿病患者并发非酒精性脂肪肝中的临床意义

doi:10.3969/j.issn.2095-9400.2020.02.010

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Abstract Objective: To evaluate the muscle fat ratio in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease (NAFLD). Methods: A total of 394 patients with type 2 diabetes mellitus from the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from April to August 2017 were enrolled in this study. The patients were divided into two groups: complicated NAFLD group (n=159) and uncomplicated NAFLD group (n=235). The clinical date such as skeletal muscle mass, visceral fat area, blood glucose, blood lipid were compared between the two groups. Pearson correlation analysis was for analyzing the relationship between muscle fat ratio and metabolic risk factors, multivariate logistic regression for the effect of muscle fat ratio on the development of NAFLD, and ROC curve for the predictive value of muscle fat ratio for NAFLD. Results: Compared with uncomplicated NAFLD group, body mass, body mass index, waist circumference, visceral fat area, body fat percentage, diastolic blood pressure, blood uric acid, glycated hemoglobin level, TC and TG were significantly higher in complicated NAFLD group, while muscle fat ratio and limb skeletal muscle mass lower (P<0.05). Pearson correlation analysis revealed a negative correlation between muscle fat ratio and body mass index, waist circumference, and systolic blood pressure in the male group (r=
-0.365, -0.437, -0.117, P<0.01), and a negative correlation between muscle fat ratio and body mass index and waist circumference in the female group (r=-0.190, -0.212, P<0.01). Multivariate analysis revealed that muscle fat ratio was an independent risk factor for NAFLD in female with type 2 diabetes (OR=4.21, 95%CI=1.31-13.52, P=0.016). ROC curve analysis showed that the area under AUC curve of male group and female group was 0.66 and 0.63 respectively. Conclusion: The level of muscle fat ratio is closely related to the occurrence of NAFLD in type 2 diabetic patients, which can serve as an important reference index for clinical evaluation of type 2 diabetic patients complicated with NAFLD.

Key words： diabetes mellitus, type 2 non-alcoholic fatty liver skeletal muscle mass visceral fat area skeletal muscle mass to visceral fat area ratio

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	ZHANG Fan
	SU Xiaoyou
	XU Jing
	ZHENG Chao

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2020.02.010 OR https://xb.wmu.edu.cn/EN/Y2020/V50/I2/135

[1] VERNON G, BARANOVA A, YOUNOSSI Z M. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults[J]. Aliment Pharmacol Ther, 2011, 34(3): 274-285.
[2] YOUNOSSI Z M, STEPANOVA M, AFENDY M, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008[J]. Clin Gastroenterol Hepatol, 2011, 9(6): 524-530.
[3] WILLIAMS C D, STENGEL J, ASIKE M I, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study[J]. Gastroenterology, 2011, 140(1): 124-131.
[4] LOOMBA R, ABRAHAM M, UNALP A, et al. Association between diabetes, family history of diabetes, and risk of nonalcoholic steatohepatitis and fibrosis[J]. Hepatology, 2012, 56(3): 943-951.
[5] CHANG Y, JUNG H S, YUN K E, et al. Cohort study of non-alcoholic fatty liver disease, NAFLD fibrosis score, and the risk of incident diabetes in a Korean population[J]. Am J Gastroenterol, 2013, 108(12): 1861-1868.
[6] TARGHER G, BERTOLINI L, RODELLA S, et al. Non-alcoholic fatty liver disease is independently associated with an increased prevalence of chronic kidney disease and proliferative/laser-treated retinopathy in type 2 diabetic patients [J]. Diabetologia, 2008, 51(3): 444-450.
[7] 陈炽华, 杨文洁, 严福华. 内脏脂肪体积及常见肥胖指标与非酒精性脂肪肝的相关性研究[J]. 放射学实践, 2017, 32(5): 436-440.
[8] KIM H Y, KIM C W, PARK C H, et al. Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults: the Fifth Korea National Health and Nutrition Examination Survey[J]. Hepatobiliary Pancreat Dis Int, 2016, 15(1): 39-47.
[9] 汪孟真, 孙少俐. 老年人肌少性肥胖研究进展[J]. 中国实用医药, 2019, 14(1): 197-198.
[10] 中华医学会肝病学分会脂肪肝和酒精性肝病学组. 非酒精性脂肪性肝病诊疗指南(2010年修订版)[J]. 现代医药卫生, 2011, 27(5): 641-644.
[11] LUKASKI H C, JOHNSON P E, BOLONCHUK W W, et al. Assessment of fat-free mass using bioelectrical impedance measurements of the human body[J]. Am J Clin Nutr, 1985, 41(4): 810-817.
[12] IDA M, HIRATA M, ODORI S, et al. Early changes of abdominal adiposity detected with weekly dual bioelectrical impedance analysis during calorie restriction[J]. Obesity (Silver Spring), 2013, 21(9): E350-353.
[13] CRUZ-JENTOFT A J, BAEYENS J P, BAUER J M, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People[J]. Age Ageing, 2010, 39(4): 412-423.
[14] 黄一沁, 胡晓娜, 史冬梅, 等. 上海老年人非酒精性脂肪肝的流行情况及相关危险因素调查[J]. 老年医学与保健, 2012, 18(2): 99-102.
[15] SHIDA T, AKIYAMA K, OH S, et al. Skeletal muscle mass to visceral fat area ratio is an important determinant affecting hepatic conditions of non-alcoholic fatty liver disease[J]. J Gastroenterol, 2018, 53(4): 535-547.
[16] BAUMGARTNER R N. Body composition in healthy aging [J]. Ann N Y Acad Sci, 2000, 904: 437-448.
[17] LIM S, KIM J H, YOON J W, et al. Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA)[J]. Diabetes Care, 2010, 33(7): 1652-1654.
[18] HONG H C, HWANG S Y, CHOI H Y, et al. Relationship between sarcopenia and nonalcoholic fatty liver disease: the Korean Sarcopenic Obesity Study[J]. Hepatology, 2014, 59(5): 1772-1778.
[19] KIM T N, PARK M S, YANG S J, et al. Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the Korean Sarcopenic Obesity Study (KSOS)[J]. Diabetes Care, 2010, 33(7): 1497-1499.
[20] TARGHER G, LONARDO A, BYRNE C D. Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus[J]. Nat Rev Endocrinol, 2018, 14(2): 99-114.
[21] MESSIER V, RABASA-LHORET R, BARBAT-ARTIGAS S, et al. Menopause and sarcopenia: A potential role for sex hormones[J]. Maturitas, 2011, 68(4): 331-336.
[22] EGUCHI Y, MIZUTAI T, SUMIDA Y, et al. The pathological role of visceral fat accumulation in steatosis, inflammation, and progression of nonalcoholic fatty liver disease[J]. J Gastroenterol, 2011, 46 Suppl 1: 70-78.