2型糖尿病非酒精性脂肪性肝病患者血清脂联素及内脂素的变化及其临床意义的研究  

Serum levels of adiponectin and visfatin in patients with type 2 diabetes and nonalcoholic fatty liver disease and its clinical significance

作　　者：边树伟[1] 周志安[1] 张杰[1] 贺宇[1] 

机构地区：[1]承德市中心医院老年病科,067000

出　　处：《中国糖尿病杂志》2015年第2期131-134,共4页Chinese Journal of Diabetes

摘　　要：目的探讨T2DM合并非酒精性脂肪性肝病(NAFLD)患者血清脂联素(APN)和内脂素的变化及临床意义。方法选取2011年9月至2013年3月于我院就诊的T2DM患者240例,根据中华医学会NAFLD诊断标准将研究对象分为单纯T2DM组148例和T2DM合并NAFLD组92例,另选正常体检者106名(NC组)。根据影像学诊断再将T2DM合并NAFLD组分为轻度亚组33例,中度亚组30例和重度亚组29例,比较各亚组血清APN和内脂素水平。结果 T2DM组和T2DM合并NAFLD组内脂素、BMI、WC、WHR、AST、ALT、FPG、FIns、TG、TC及胰岛素抵抗指数(HOMA-IR)较NC组升高(P<0.05或P<0.01)。T2DM合并NAFLD组血清APN水平较NC组和T2DM组降低(P<0.01),T2DM组较NC组降低(P<0.01)。T2DM合并NAFLD组轻、中、重度亚组HOMA-IR逐渐升高;血清APN水平逐渐降低,且轻、中、重度亚组间比较差异均有统计学意义(P<0.05);血清内脂素水平逐渐升高,但轻度和中度亚组间比较差异无统计学意义(P>0.05)。结论T2DM合并NAFLD患者血清APN较正常人明显降低,且与NAFLD严重程度相关。低脂联素血症可能与NAFLD发生发展有关;内脂素水平随NAFLD严重程度升高,提示可能参与了向脂肪性肝炎及肝脏纤维化的发展。Objective To investigate the serum levels of adiponectin（APN）and visfatin in patients with type 2 diabetes and nonalcoholic fatty liver disease（NAFLD）and its clinical significance. Methods230 cases of T2DM patients admitted to our hospital from September 2011 to March 2013 were divided into T2 DM group（148cases）and T2DM plus NAFLD group（92cases）according to the Chinese Medical Association diagnostic criteria for NAFLD subjects.106 healthy people was selected as control.Patients with T2DM plus NAFLD were further divided into mild（38 cases）,moderate（28cases）and severe（26cases）groups based on NAFLD severity.Serum APN and visfatin levels were compared among groups.Results Compared with NC group,T2DM and T2DM plus NAFLD groups showed the increased levels of visfatin,BMI,WC,WHR,ALT,ALT,FPG,FIns,TG,TC and HOMA-IR（P 0.05 or P〈0.01）.Serum APN levels were lower in T2DM plus NAFLD than in NC group and T2DM group（P〈0.01）and serum APN levels were lower in T2DM group than in NC group（P〈0.01）.HOMA-IR was positively correlated to disease severity in patients with T2DM plus NAFLD;serum APN levels were negatively correlated to disease severity（both P〈0.05）;visfatin level was positively correlated to disease severity in patients with T2DM plus NAFLD,but the difference between mild and moderate groups was not statistically significant（P〈0.05）. Conclusion APN is significantly lower in patients with T2DM plus NAFLD than in normal individuals,and is correlated with NAFLD severity.Hypoadiponectinemia may be related to the development of NAFLD;visfatin significantly is increasedin severe NAFLD and NAFLD may be involved in the development of liver fibrosis.

关 键 词：非酒精性脂肪性肝病 糖尿病 2型 脂联素 内脂素 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]