糖尿病脂肪肝血浆网膜素水平及相关因素分析  

Plasma omentin level and related factors in type 2 diabetes mellitus combined with fatty liver disease

作　　者：李雪粉[1] 邸阜生[1] 王璐[2] 贾国瑜[2] 张洁[2] 李强[2] 余红艳[1] 

机构地区：[1]天津医科大学第三中心临床学院内分泌科,300170 [2]天津市第三中心医院内分泌科天津市人工细胞重点实验室,300170

出　　处：《中国医师进修杂志》2012年第34期1-4,共4页Chinese Journal of Postgraduates of Medicine

基　　金：天津市卫生局科技基金（2010KR02）

摘　　要：目的测定2型糖尿病（T2DM）和非酒精性脂肪性肝病（NAFLD）患者血浆网膜素水平，探讨网膜素与糖脂代谢、胰岛素抵抗以及NAFLD的相关性。方法采用酶联免疫吸附试验法检测50例T2DM合并NAFLD（A组）、50例T2DM不合并NAFLD（B组）、51例糖代谢正常合并NAFLD（C组）和49例糖代谢正常不合并NAFLD（D组）血浆网膜素水平，同时检测空腹血糖、糖化血红蛋白（HbA1c）、血脂、空腹胰岛素（FINs）等临床指标，计算体质指数、腰臀比和稳态模型评估法胰岛素抵抗指数（HOMA-IR）。结果A、B、C和D组的血浆网膜素水平分别为（17．85±3．68）、（13．89±10．68）、（26．05±7．26）、（22．92±2．71）μg／L，A组和B组均低于c组和D组，A组高于B组，c组高于D组，差异均有统计学意义（P〈0．05）。相关分析显示：血浆网膜素水平与体重、体质指数、腰围、三酰甘油、空腹血糖、nNs、HOMA—IR呈负相关（P〈0．05或〈0．01），与HDL．C呈正相关（P〈0．01）。多元逐步回归分析显示：体质指数、HOMA．IR、FINS是影响血浆网膜素水平的独立相关因素。受试者工作特征曲线显示，糖代谢正常人血浆网膜素水平24．82μg／L可作为预测NAFLD的风险值。结论血浆网膜素水平与糖脂代谢、胰岛素抵抗密切相关，并可能在T2DM和NAFLD的发生、发展中起重要作用。Objective To assay the plasma omentin level in patients of type 2 diabetes mellitus （T2DM） combined with non-alcoholic fatty liver disease （NAFLD） and investigate the relationship between plasma omentin level, glucose and lipid metabolism, insulin resistance and NAFLD. Methods The plasma omentin level was assayed by enzyme-linked immunosorbent assay（ELISA） in all subjects, including patients of T2DM controls with NAFLD （group A, 50 cases ）, T2DM without NAFLD （group B, 50 cases）, simple with NAFLD （group C, 51 cases ） and normal controls （group D, 49 cases）. Meanwhile, blood glucose, glycosylated hemoglobin（HbAlc）, lipids and insulin levels were also measured. Body mass index （BMI） and waist-to-hip ratio were evaluated. Insuhn sensitivity was assessed by HOMA-IR. Results The plasma omentin level was （17.85±3.68）, （13.89±10.68）, （26.05±7.26） and （22.92±2.71）μg/L in group A,B,C and D respectively. The plasma omentin level of group A and group B was significantly lower than that of group C and group D（P〈 0.05）. The plasma omentin level of group A was higher than that of group B（P〈 0.05）. The plasma omentin level of group C was higher than that of group D （P 〈 0.05 ）. Correlation analysis showed that the plasma omentin level was negatively correlated to weight, BMI,waist, triglyceride, fasting blood glucose, fasting insulin （FINS） and HOMA-IR （P 〈0.05 or 〈0.01）,and positively correlated to high-density hpoprotein cholesterol （HDL-C）（P 〈0.01）. Multiple stepwise regression analysis showed that BMI, HOMA-IR and FINS was independent variable of omentin. The concentration of omentin was 24.82 μg/L which could predict the risk of NAFLD in people with normal glucose regulation. Conclusions The plasma omentin level is closely correlated with glucose,lipid metabolism and insulin resistance. Plasma omentin may play an important role in the pathogenesis of T2DM and NAFLD.

关 键 词：糖尿病 2型 脂肪肝 网膜素 

分 类 号：R587.1[医药卫生—内分泌]