Analysis On Risk Factors Of Atherosclerotic Disease In Patients With Type 2 Diabetes Mellitus And Non-alcoholic Fatty Liver Disease

Objective :To investigate the relationship between the intima-media thickness(IMT) ,intercellular adhesion molecule -1(ICAM-1) and C-reactive protein(CRP) of type 2 diabetes mellitus(T2DM) with non-alcoholic fatty liver disease and to evaluate the effect of ICAM-1 and CRP on atherosclerosis(AS) of these group.Methods:85 cases with T2DM were divided into two groups: with non -alcoholic fatty liver disease (NAFLD, n=41) and no non-alcoholic fatty liver disease (NNAFLD, n=44). The serum levels of fasting plasma glucose(FPG), fasting insulin(FINS), ICAM -1, CRP, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol(LDL-C), total cholesterol(TC), triglyceride (TG), alanine aminotransferase (ALT), aspartate aminotransf -erase (AST),glycosylated hemoglobin A1c(HbA1c), two hour plasma glucose (2hPG), two hour insulin(2hINS) were detected. Body mass index (BMI),and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. A multiple stepwise regression analysis was used on IMT as the dependent variable, and the levels of ICAM-1, CRP, FINS, HDL -c, LDL-c, TC, TG, ALT,AST, HbA1c, BMI, HOMA-IR as the independent variables .Statistics software SPSS17.0 was used for data processing. All the measurement data Was expressed as (mean士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 was analyzed by Logistic regression.Results :①There is no difference in age ,sexuality, BP, course of disease,SBP,DBP,HDL-c,ALT,AST between two groups. BMI , TG,TC and LDL-c in NAFLD group were higher than those in NNAFLD group in statistics (P<0.05).②Compare HbA1c,glucose and insulin in two groups: the levels of HbA1c, FPG,2hPG,FINS,2hINS and HOMA-IR were higher than control group (P<0.05 OR P<0.01).③To compare C-IMT,ICAM-1 and CRP in two groups, we can see that C-IMT ,ICAM-1 and CRP were higher in NAFLD group compared to the control cases, the former two were significantly higher than the control cases, but the latter had no statistical significance .④A linear correlation analysis was used on IMT,age,course,SBP,DBP,BMI,HbA1c,FPG,2hPG, FINS, 2hINS, TC, TG, LDL- c, HDL- c, ALT,AST,ICAM-1 and CRP in NAFLD group .IMT levels were positively correlated with BMI,HbA1C,FPG,2hPG,FINS,2hINS,HOMA-IR,TG,LDL-c,ICAM-1 and CRP(,P<0.05 OR P<0.01).⑤A multiple stepwise regression analysis was used on IMT as the dependent variable, and the levels of age, BP,DBP,BMI,HbA1C, FPG,2hPG,FINS,2hINS, TC, TG,LDL- c, HDL- c, ALT,AST,ICAM-1 and CRP as the independent variables in NAFLD group. It revealed that HOMA -IR, LDL- c, CRP and TG entered regression equation in NAFLD group , which was positively correlated with IMT levels.Conclusions :①Type 2 diabetes individuals with non-alcoholic fatty liver disease are characterized by both metabolic disorder and insulin resistant, and relate to development and progression of atherosclerotic disease .②HOMA -IR,LDL-c, CRP, and TG were the most influential factors that affected IMT levels in type 2 diabetes individuals with NAFLD ,so we deduced that with the in crease of insulin resistant ,lipid disorder, high level of CRP were all particip -ated in the formation and progress of atherosclerosis.