Investigation Of The Relationship Between The Risk Factors Of Atherosclerosis And Nonalcoholic Fatty Liver In Type2Diabetes

ObjectiveWe regard intima-media thicknes (IMT) and ankle-berahcial index(ABI) as parameters to investigate the relationship between the risk factors of atherosclerosis and type2diabetes(T2DM) with non-alcoholic fatty liver disease(NAFLD).MethodsOne hundred and six type2diabetic patients were divided into two groups (NAFLD Group,n=66and non-NAFLD group,n=40) by liver ultrasound and laboratory exam certificates. Carotid artery intima-media thickness (IMT) were measured by colorful doppler ultrasonography and ankle-berahcial index(ABI) were determined by doppler flowmeter. Then their clinical information such as body mass index(BMI), systolic blood pressure(SBP),diastolic blood pressure(DBP), fasting plasma glucose(FPG), two hour plasma glucose(2hPG), fasting insulin(FINS), two hour insulin(2hINS), homeostasis model assessment of insulin resistance (HOMA-IR), glycosylated hemoglobin Alc(HbAlc), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), total cholesterol(TC), aspartate aminotransferase(AST), alanine aminotransferase(ALT), homocysteine(Hcy) were collected.All data were analysis by SPSS17.0analysis software.Results①There is no statistics significance in age,sexuality,BP,course of disease between two groups(P>0.05).BMI in NAFLD group was higher than those in non-NAFLD group in statistics(P<0.05).②The levels of HbAlc, FPG,2hPG, FINS,2hINS in NAFLD group were higher than control group(P<0.05). And HOMA-IR in NAFLD group was significantly higher than control group(P<0.01).③There is no difference in HDL-C,ALT,AST between two groups(P>0.05).The levels of the serum TG，serum LDL-C of NAFLD group were significantly higher than B group(P<0.01). And The level of TC in NAFLD group was much higher than control group(P<0.05).④IMT,Hcy,left and right ankle brachial index were higher in NAFLD group compared to the control group(P<0.05or P<0.01), difference has statistics meaning.⑤According to the Pearson correlation analysis about IMT and other factors in NAFLD group:IMT was positively correlated with BMI、HbA1C、FPG、2hPG、 FINS、2hINS、HOMA-IR、TG、LDL-C and Hey (P<0.05or P<0.01),and was negatively correlated with HDL-C and Hcy, difference has statistics meaning.⑥A multiple stepwise regression analysis was used on IMT as the dependent variable,and other factors as the independent variables in NAFLD group:the influence factors to IMT screened are HOMA-IR,LDL-C,TG and Hey.Conclusion1. If T2DM patients are combined with NAFLD, they will develop more atherosclerosis and be at greater risk of developing metabolic disorder, insulin resistant and cardiovascular complications.2. HOMA-IR,LDL-C, TG and Hey were the most influential factors that affected IMT levels in T2DM patients with NAFLD,so we deduced that the increase degree of insulin resistant,lipid disorder,high level of Hcy were all closely related to the origin and development of atherosclerosis. Therefore, a better prognosis depends on early drug and life style of intervention.