糖尿病脂肪肝患者血浆CHGA与ATGL水平相关性研究  

The Correlation Analysis of CHGA and ATGL in Patients of Type 2 Diabetes Mellitus with Nonalcoholic Fatty Liver Disease

作　　者：刘玉清[1] 邸阜生[2] 贾国瑜[2] 王璐[2] 李强[2] 张洁[2] 邵金双 

机构地区：[1]天津医科大学三中心临床学院,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

出　　处：《天津医药》2014年第1期13-16,共4页Tianjin Medical Journal

基　　金：天津市卫生局科技基金资助项目(项目编号:2010KR02)

摘　　要：目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者血浆嗜铬蛋白A(CHGA)与脂肪组织三酰甘油脂肪酶(ATGL)的相关性。方法采用酶联免疫吸附法检测T2DM合并NAFLD组(A组,74例)、T2DM不合并NAFLD组(B组,76例)和正常对照组(NC组,75例)血浆CHGA和ATGL水平,分析各代谢指标与CHGA、ATGL的相关性,回归分析T2DM合并NAFLD的影响因素。结果血浆CHGA(μg/L)水平在A组(83.15±9.46)、B组(70.90±2.75)均高于NC组(46.74±8.15),A组高于B组(均P<0.01)。血浆ATGL(μg/L)水平在A组(21.36±13.42)、B组(40.29±22.83)均低于NC组(72.30±26.41),A组低于B组(均P<0.01)。在A组患者中,血浆CHGA与ATGL、碳水化合物氧化率呈负相关,与空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、游离脂肪酸(FFA)、脂肪氧化率呈正相关;血浆ATGL水平与体质指数(BMI)、FINS、胆固醇(TC)、三酰甘油(TG)、HOMA-IR呈负相关,与FFA呈正相关。多元逐步线性回归分析显示:FINS、ATGL、FFA是影响CHGA水平的因素。Logistic回归分析显示:CHGA、ATGL、FFA水平是T2DM合并NAFLD的影响因素。结论血浆CHGA和ATGL与糖脂、能量代谢密切相关,且两者可能通过相互作用影响T2DM合并NAFLD的发生发展。Objective To investigate the relationship between plasma levels of chromogranin A （CHGA） and adi- pose triglyceride lipase （ATGL） in patients with type 2 diabetes （T2DM） combined non-alcoholic fatty liver disease （NAFLD）. Methods The plasma levels of CHGA and ATGL were assayed by enzyme-linked immunosorbent assay （ELISA） in T2DM patients with NAFLD （group A, n=74）, T2DM without NAFLD （group B, n=76）, and normal group （group NC, n= 75）. The correlation between CHGA, ATGL and other metabolic index was analyzed. Results The plasma level of CHGA was significantly higher in group A （83.15＋9.46） and group B （70.90＋2.75） than that of group NC （46.74~8.15, P 〈 Q.Ol）, and the level of CHGA was significantly higher in group A than that of group B （P 〈 0.01）. The plasma level of ATGL was sig- nificantly lower in group A （21.36~13.42） and group B （40.29-＋22.83） than that of group NC （72.30-＋26.41, P 〈 0.01）, and the level was lower in group A than that of group B （P 〈 0.01）. There was a negative correlation between the plasma CHGA, AT- GL and carbohydrate oxidation rate in group A. There was a positive correlation between fasting insulin （FINS）, insulin resis- tance index （HOMA-IR）, free fatty acid （FFA） and fat oxidation rate in group A. There was a negative correlation between plasma level ATGL and body mass index （BMI）, FINS, cholesterol （TC）, triglyceride （TG） and HOMA-IR, meanwhile, it was positively correlated with FFA. The multiple stepwise regression analysis showed that FINS, ATGL and FFA were indepen- dent variables for CHGA. The Logistic regression analysis showed that plasma levels of CHGA, ATGL and FFA were the in- dependent predictors of T2DM with NAFLD. Conclusion The plasma levels of CHGA and ATGL are closely correlated with substance and energy metabolism, and the interaction between them may play an important role in the pathogenesis of T2DM with NAFLD.

关 键 词：糖尿病 2型 脂肪肝 脂肪酸类 非酯化 嗜铬蛋白A 三酰甘油脂肪酶 

分 类 号：R575.5[医药卫生—消化系统] R587.1[医药卫生—内科学]