Clinical Study Of Nonalcoholic Fatty Liver Disease And Urinary Albumin Excretion Rate In Patients With Type 2 Diabetic Nephropathy

Objective:To investigate the relationship between nonalcoholic fatty liver(NAFLD)and urinary albumin excretion rate(UAER)in type 2 diabetic nephropathy,and to analyze the influencing factors of NAFLD and UAER.Methods:248 patients with T2 DM were enrolled in this study.According to whether or not with NAFLD was divided into T2 DM with NAFLD group(group A)and T2 DM withou NAFLD group(group B),The blank control group(group C)was 60 patients with NAFLD for healthy examination.The differences in age,duration of diabetes,prevalence of hypertension,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,body mass index,insulin resistance,biochemical indexes,e GFR and UAER were compared among the three groups.The relationship between NAFLD and UAER was analyzed by chi-square test;Then,the univariate analysis was used as the independent variable,the NAFLD and UAER were used as the dependent variable to analyze the influencing factors of NAFLD and UAER.Results:Of the 248 patients with T2 DM,there were 105 patients(42.34%)in group A and 143 patients(57.66%)in group B,including 96 patients in normal group and 152 patients in urine microalbuminuria group,and no large amount of proteinuria.There were no significant differences in TBIL,DBIL,IBIL,ALP,Cr,TC,LDL,CYSC and the prevalence of hypertension in the three groups(P>0.05);Compared with group C,group A had higer age,SBP,BUN,FPG,FMN,Hb A1 c,LNUAER(natural logarithm of UAER),while BMI,ALT,AST and HDL were lower,the difference was statistically significant(P<0.05),group B had significantly higer SBP,DBP,GGT,FPG,FMN,TG,LNUAER,Hb A1 c,HOMA-IR,e GFR,and lower HDL,the difference was statistically significant(P<0.05).Compared with group A,group B had significantly higer BMI,ALT,AST,GGT,FPG,TG,HOMA-IR,LNUAER,e GFR,while age,duration of diabetes mellitus,HDL were lower,the difference was statistically significant(P<0.05).The incidence of microalbuminuria in NAFLD group was higher than that in without NAFLD group,the difference was statistically significant(?2=7.465,P<0.05).Multivariate logistic regression analysis showed that age(OR = 0.201,95% CI 0.067-0.605)was a protective factor for NAFLD,BMI(OR = 23.301,95%CI 9.322-58.243),HOMA-IR(OR=8.710,95%CI 3.668-20.681),TG(OR=3.189,95%CI 1.273-7.987),UAER(OR=6.369,95%CI 2.178-18.619)were independent risk factors for NAFLD.Age(OR=2.205,95%CI 4.217-19.523)?TG(OR=2.611,95%CI 1.270-5.369)?NAFLD(OR=4.556,95%CI 1.883-11.025)were independent risk factors for UAER.Conclusion:1.Patients with type 2 diabetic nephropathy with NAFLD had a higher risk of microalbuminuria than those who did not have NAFLD;2.TG and NAFLD were independent risk factors for UAER.