2型糖尿病患者肝脾CT值比值与胰岛素抵抗的关系  

Relation between CT Ratio of Liver and Spleen and Insulin Resistance in Patients with Type 2 Diabetes

作　　者：肖木芳 冉建民[1] 步军[2] 张杨[1] 梅光中 劳干诚[1] 

机构地区：[1]暨南大学医学院附属广州红十字会医院内分泌科,广东广州510220 [2]暨南大学医学院附属广州红十字会医院放射科,广东广州510220 [3]暨南大学医学院附属广州红十字会医院医学体检中心,广东广州510220

出　　处：《临床医学工程》2017年第5期622-624,共3页Clinical Medicine & Engineering

基　　金：广州市科学研究专项项目(项目编号:2014J4100076)

摘　　要：目的探讨不同肥胖程度的2型糖尿病患者肝脾CT值比值与胰岛素抵抗(IR)指标的相关性。方法选取我院收治的13例2型糖尿病患者作为糖尿病组,按体重指数(BMI)分为糖尿病肥胖组(7例)和糖尿病非肥胖组(6例)。另选取31例正常糖耐量者作为对照组,按BMI分为对照肥胖组(7例)和对照非肥胖组(24例)。通过CT测定其肝脾CT值比值,检测其生化指标,计算胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(HOMA-B)。比较各组的上述指标并分析其与IR的相关性。结果糖尿病组的肝脾CT值比值显著低于对照组,两组中的肥胖亚组的肝脾CT值比值均低于非肥胖亚组(P均<0.05)。糖尿病组的ln-HOMA-IR显著高于对照组,两组中的肥胖亚组的ln-HOMA-IR均高于非肥胖亚组(P<0.05)。Pearson's相关分析显示,肝脾CT值比值与ln-HOMA-IR、BMI呈负相关(r=-0.471,P=0.001;r=-0.434,P=0.003)。多元线性回归分析显示,ln-HOMA-IR和BMI是肝脾CT值比值的独立危险因素(R^2分别为0.227、0.296,P均<0.01)。结论 2型糖尿病合并肥胖患者的肝脾CT值比值明显降低;IR和肥胖是其独立危险因素,可能与非酒精性脂肪肝发病密切相关。Objective To explore the relation between CT ratio of liver and spleen and insulin resistance （IR） in patients with type 2 diabetes and different obesity degree. Methods 13 cases of patients with type 2 diabetes admitted to our hospital were selected as the diabetes group and divided into obese-diabetic group （7 cases） and non-obese-diabetic group （6 cases） according to their body mass index （BMI）. 31 cases of patients with normal glucose tolerance were selected as the control group and divided into obese-control group （7 cases） and non-obese-control group （24 cases） according to their BMI. The CT ratio of liver and spleen was quantified by CT, the biochemical indicators were measured, and the insulin resistance index （HOMA-IR） and insulin sensitivity index （HOMA-B） were evaluated. The above indicators were compared among all groups and the relation with insulin resistance was analyzed. Results The CT ratio of liver and spleen of diabetes group was significantly lower than that of control group, and the CT ratio of liver and spleen of both obese subgroups were lower than those of non-obese subgroups （all P 〈0.05）. The ln-HOMA-IR of diabetes group was significantly higher than that of control group, and the ln-HOMA-IR of both obese subgroups were higher than those of non-obese subgroups （all P 〈0.05）. Pearson＇s relation analysis showed that the CT ratio of liver and spleen was negatively related to ln-HOMA-IR （r = -0.471, P= 0.001） and BMI （r = -0.434, P= 0.003）. Multiple linear regression analysis showed that ln-HOMA-IR （Rz = 0.227） and BMI （R2 = 0.296） were independent risk factors of CT ratio of liver and spleen （P 〈0.01）. Conclusions The CT ratio of liver and spleen of patient with type 2 diabetes complicated with obesity significantly decreases. IR and obesity are the independent risk factors for CT ratio of liver and spleen, which is closely related to the attack of NAFLD.

关 键 词：2型糖尿病 肝脾CT值比值 非酒精性脂肪肝 肥胖 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]