The Investigation Of The Relationship Between Insulin Resistance And Non-alcoholic Fatty Liver In Patients With Type 2 Diabetes Mellitus

Morden life style and poor healthy awareness made people's activity become less and less .Unreasonable diet such as higher calorific, higher fat, higher protein and lower fibrin lead to overweight and fat which cause increasing rate of diabetes, hypertension, hyperlipemia. With the increase of diabetes mellitus's incidence rate and ultrasonography's popularization, the detection rate of the type 2 diabetes affiliated with non-alcoholic fatty liver. Nonalcoholic fatty liver is the third of hepatopathy, which are dangerous to people's health, and it is close to the decompensation of liver cirrhosis. In recent years, many studies indicate that insulin resistance is the basement of metabolic syndrome's pathology. Insulin resistance and disturbance of carbohydrate metabolism may be the primary cause of the fatty liver.Object: T0 investigate the relationship between insulin resistance and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. meanwhile, to talk about the risk factors of non-alcoholic fatty liver.Methods: The patients were selected in our hospital from March,2008 to January,2009. A total of 30(16 males and 14 females) patients of type 2 diabetes with non-alcoholic fatty liver and 30(18 males and 12 females) type 2 diabetes without fatty liver were entered into study . They must be fit these standard: (1) the diagnosis standard made in 1999 of WHO; (2) excluded patients whose therapy is hypo-dermica insulin; (3) excluded patients who drunk or the total alcohol is more than 40g every week; and excluded patients who had virus hepatitis, drug-induced liver disease, Wilson, parenteral nutrition, autoimmune liver disease, serious infection, the acute complication of diabetes mellitus; (4) fit the diagnosis standard of fatty liver. All people in the study were measured body height, weight, waistline, and calculated BMI (calculated as weight in kilograms divided by height in meters squared). After the subjects had fasted 12 hours at the time examination, fasting and post-prandial glucose levels, serum insulin, cholesterol-total, serum triglycerides, serum LDL cholesterol, serum HDL cholesterol, aspartate amino transferase, alanine aminotransferase.Insulin resistance index(HOMA-IR) = FBG×FIN/22.5.Statistic software SPSS13.0 was used for data processing. All the measurement data was expressed as (mean±standard deviation) and was analyzed by t-test; The numeration data was analyzed by Chi-square test. The risk factor about non-alcoholic fatty liver disease was analyzed by Logistic regression. Results: The levels of body mass index, waistline and insulin resistance index increased significantly in fatty liver group compared with non-fatty liver disease group (p<0.01); the levels of serum low density lipoprotein, serum triglyceride, serum total cholesterol, OGTT-2h plasma glucose and serum insulin,fasting serum insulin increased in fatty liver disease group compared with non-fatty liver disease group (p<0.05); the levels of serum creatinine, fasting plasma glucose, blood uric acid, serum high density lipoprotein, serum transaminase had no statistical significance between two groups (p>0.05). Analysis of Logistic regression showed that HOMA-IR, body mass index, waistline, serum triglyceride and HOMA-IR were the risk factors of non-alcoholic fatty liver (p<0.01, OR=0.576, 0.858, 0.538, 1.81).Conclusions: (1)Non-alcoholic fatty liver disease in patients with T2DM had remarkable overweight, central obesity, dyslipidemia and insulin resistance; Insulin resistance index, body mass index, waistline, serum triglyceride and HOMA-IR were risk factors of non-alcoholic fatty liver disease.(2) As insulin resistance play an important role in occurring of non-alcoholic fatty liver, So it is very necessary to improve insulin resistance.(3)To the patients of type 2 diabetes with non-alcoholic fatty liver, They should improve the life style, such as reasonable diet, movement, control body weight .Actively controlling the blood glucose and blood fat prevent fatty liver further aggravation,and also is beneficial to postpone the progress of the diabetes and the depletion of the B cell.