摘要
目的:探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者的临床特征,血清脂联素(APN)、瘦素(Leptin)和脂联素/瘦素比值(A/L)的变化及其临床意义。方法:选取正常对照组55例,2型糖尿病组117例,分为单纯2型糖尿病组(T2DM组)(n=58)、2型糖尿病合并非酒精性脂肪性肝病组(T2DM+NAFLD组)(n=59),收集临床及生化资料,酶联免疫法测定血清脂联素和瘦素水平,计算二者比值。应用SPSS18.0进行相关统计学分析。结果:(1)T2DM+NAFLD组的患者DBP、ALT、TC水平均高于对照组(P<0.01),BMI、AST、TG、FPI均高于对照组和单纯T2DM患者(P<0.05、P<0.01),HDL-c、APN和A/L水平低于对照组和单纯T2DM患者(P<0.01)。(2)回归分析显示FPG、病程和HDL-c是脂联素水平的独立预测因素,APN及BMI是胰岛素抵抗预测因子;TG是T2DM合并NAFLD的危险因素,APN是其保护因素(OR 0.561,95%CI 0.45～0.70,P<0.01)。结论:低脂联素血症可能在T2DM合并NAFLD的发生、发展中起一定的作用,可以血清脂联素预测胰岛素抵抗(IR)。瘦素在T2DM合并NAFLD中的作用尚需进一步研究。
Objective： To investigate the characteristics of type 2 diabetic（T2DM ） patients with nonalcoholic fatty liver disease（NAFLD ） and changes of serum adiponectin （APN）, leptin levels and the ratio of adiponectin to leptin （A/L） and their clinical significances. Methods： The serum levels of APN and leptin were measured from the serum of 58 T2DM patients with NAFLD （T2DM＋NAFLD group）, 59 T2DM patients without NAFLD （T2DM group） and 55 control subjects with normal glucose tolerance and without NAFLD（normal control, NC group）. Results： （1）DBP, ALT and TC level were significantly higher in T2DM＋NAFLD group than those in NC group, while BMI, AST, TG, FPI level were also markly increased（P〈0.05, P〈0.01 ）and APN and HDL level in serum and A/L were significantly lower （P〈 0.01）, compared with those in NC and T2DM group. Nevertheless, leptin level in serum had no statistically significance between the three groups.（2） Regression analysis showed FPG, duration and HDL levels were independent predicting factors for APN level, BMI and APN were the predictors for HOMA-IR. TG was independent risk factors for T2DM complicated NAFLD, while APN level was the protection one （OR=0.561, 95% CI 0.40-0.7, P〈0.01 ）. Conclusion： Hypoadiponectinemia may partly play an important role in the development and progression of NAFLD in T2DM, for another adipokine leptin, is still under study. APN level in serum might be used to assess insulin resistance（IR） in T2DM with NAFLD.
出处
《天津医科大学学报》
2013年第1期61-64,共4页
Journal of Tianjin Medical University
关键词
脂联素
瘦素
糖尿病
2型
非酒精性脂肪性肝病
adiponectin
leptin
diabetes mellitus, type 2
fatty liver, nonalcoholic
