新诊断2型糖尿病合并非酒精性脂肪性肝病患者血浆白细胞衍生趋化因子2水平变化及意义  

Plasma levels of leukocyte cell-derived chemotaxin 2 in patients with newly diagnosed type 2 diabetes complicated with non-alcoholic fatty liver disease and its association with insulin resistance

作　　者：曾惠娴[1] 张振[1] 林江虹[1] 胡颖辉[1] 陈宏[1] 

机构地区：[1]南方医科大学珠江医院内分泌代谢科,广州市510282

出　　处：《实用医学杂志》2017年第7期1090-1094,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金面上项目(编号:81570716)

摘　　要：目的:观察新诊断2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者血浆白细胞衍生趋化因子2(LECT2)水平变化,并探讨其临床意义。方法:选取研究对象137例,其中新诊断T2DM合并NAFLD患者50例、单纯T2DM患者47例及正常对照者40例,采用酶联免疫吸附法(ELISA)检测血浆LECT2水平,同时进行人体测量及测定各项生化指标。结果:T2DM合并NAFLD患者血浆LECT2水平显著高于单纯T2DM组[(32.95±10.11 vs.29.08±7.54)ng/m L,P<0.01],且两组均显著高于正常对照组[(22.38±4.40)ng/m L,P<0.01]。血浆LECT2水平与体质指数、血糖、胰岛素、C肽、Hb A1c、γ-谷氨酰基转移酶、三酰甘油、HOMA-IR呈正相关,与高密度脂蛋白胆固醇、HOMA-%β呈负相关(均P<0.01)。体质指数、空腹血糖及高密度脂蛋白胆固醇是影响血浆LECT2水平的重要因素。结论:T2DM合并NAFLD患者血浆LECT2水平升高,并与胰岛素抵抗、糖脂代谢紊乱密切相关,提示LECT2可能参与胰岛素抵抗及T2DM的发生发展。Objective To observe the changes in levels of plasma leukocyte cell-derived chemotaxin 2 （LECT2） in patients with newly diagnosed type 2 diabetes （T2DM） complicated with non-alcoholic fatty liver disease （NAFLD）, and to investigate the clinical significance. Methods A total of 137 subjects were enrolled in the study, including 50 patients with newly diagnosed T2DM complicated with NAFLD, 47 patients with newly diagnosed T2DM with non-NAFLD and 40 healthy subjects. The level of plasma LECT2 was determined by ELISA. Anthropometric data and other biochemical indicators were measured in three groups. The body mass index （BMI） and waist-to-hip ratio （WHR） were calculated. Insulin resistance and pancreas β-cell function were determined by homeostasis model assessment （HOMA-IR, HOMA-%β）. Results Plasma concentration of LECT2 in patients with newly diagnosed T2DM complicated with non-NAFLD was higher than that in type 2 diabetic patients with non-NAFLD [ （32.95 ± 10.11 vs 29.08 ± 7.54） ng/mL, P 〈 0.01 ]. Plasma LECT2 levels in both groups were significantly higher than that in normal control group [ （22.38± 4.40） ng/mL, P 〈 0.01 ]. Plasma LECT2 level was positively con＇elated with BMI, FPG, FINS, C peptide, HbAlc, GGT, TG and HOMA-IR, while negatively with HDL-C and HOMA-%β （all P 〈 0.01 ）. Multivariate regression analysis showed that levels of BMI, FPG and HDL-C were important factors affecting plasma LECT2 level. Conclusions Plasma LECT2 concentration signifi- cantly elevates in patients with newly diagnosed T2DM complicated with non-NAFLD. Plasma level of LECT2 is closely correlated with insulin resistance and glycolipid metabolism. LECT2 may play an important role in the pathogenesis of insulin resistance and T2DM.

关 键 词：2型糖尿病 非酒精性脂肪性肝病 胰岛素抵抗 白细胞衍生趋化因子2 

分 类 号：R575.5[医药卫生—消化系统]