2型糖尿病患者血清脂联素与肝脏脂肪含量的相关性研究  

The correlation analysis between serum adiponectin level and liver fat content in patients with type 2 diabetes

作　　者：张珊[1] 张洁[2] 傅力[1] Zhang Shan Zhang Jie Fu Li(Department of Physiology and Pathophysiology , Tianjin Medical University, Tianfin 300070, Chin)

机构地区：[1]天津医科大学生理学与病理生理学系,300070 [2]天津市第三中心医院内分泌科,300170

出　　处：《国际内分泌代谢杂志》2017年第3期155-158,共4页International Journal of Endocrinology and Metabolism

摘　　要：目的 探讨2型糖尿病患者血清脂联素水平与肝脏脂肪含量及相关临床指标的相关性.方法 选取天津市第三中心医院收治的初发2型糖尿病患者108例,以患者肝脏脂肪含量测定结果的平均数为切点将其分为2型糖尿病伴低肝脏脂肪含量组（T2DM＋ LFC组）50例和2型糖尿病伴高肝脏脂肪含量组（T2DM＋ HFC组）58例.应用高效液相层析法、葡萄糖氧化酶法、放射免疫法以及ELISA等分别对两组患者的相关临床指标及血清脂联素水平进行检测.采用t检验或X2检验进行组间对比,采用Spearman相关分析和多元逐步回归分析进行指标间关系判定,采用Logistic回归分析影响肝脏脂肪含量的危险因素.结果 T2DM＋ HFC组血清脂联素水平显著低于T2DM＋ LFC组（t=3.947,P=0.006）.2型糖尿病患者血清脂联素水平与体重、体重指数、体脂含量、内脏脂肪面积、肝脏脂肪含量、甘油三酯水平呈显著负相关（r=-0.680 ～-0.225,P＜0.05或0.01）.多元逐步回归分析显示,体重、体重指数和体脂含量是血清脂联素水平的独立相关因素.Logistic回归分析显示,体重（OR=1.288,95％ CI：1.009 ～ 1.644）、脂联素（OR=0.169,95％ CI：0.053 ～0.542）、γ-谷氨酰胺转肽酶（OR=1.155,95％ CI：1.032～ 1.293）及甘油三酯（OR=0.323,95％ CI：0.172～0.609）为2型糖尿病患者肝脏脂肪含量的影响因素.结论 血清脂联素水平与体重、体重指数和体脂含量密切相关,并可能在2型糖尿病患者肝脏脂质沉积过程中发挥重要调节作用.Objective To investigate the relationship between serum adiponectin level and liver fat content as well as other related clinical parameters in patients with type 2 diabetes.Methods A total of 108 patients newly diagnosed with type 2 diabetes in the Third Central Hospital of Tianjin were selected.According to the liver fat content,subjects were divided into type 2 diabetic patients with low liver fat content group （T2DM ＋ LFC group,n =50） and type 2 diabetic patients with high liver fat content group （T2DM ＋ HFC group,n =58）.The related clinical indexes and serum adiponectin level were measured by high performance liquid chromatography,glucose oxidase method,radioimmunoassay or ELISA.Comparison between groups were using t test or x2 test.Spearman correlation analysis and multiple stepwise regression analysis were used to determine the relationship between indexes.Logistic regression analysis was used to analyze the risk factors of liver fat content.Results The level of serum adiponectin in T2DM ＋ HFC group was significantly lower than that in T2DM ＋ LFC group （t =3.947,P =0.006）.The level of serum adiponectin was negatively correlated with body weight,body mass index,body fat,visceral fat area,liver fat content,and triglyceride in type 2 diabetic patients （r =-0.680--0.225,P 〈 0.05 or 0.01）.Stepwise regression indicated that body weight,body mass index and body fat content were independent correlated factors of serum adiponectin level.Logistic regression analysis showed that body weight （OR =1.288,95% CI：1.009-1.644）,adiponectin （OR =0.169,95% CI：0.053-0.542）,γ-glutamine transpeptidase （OR =1.155,95% CI.1.032-1.293） and triyglyceride （OR =0.323,95% CI：0.172-0.609） were risk factors for liver fat content in patients with type 2 diabetes.Conclusion Level of serum adiponectin is affected by body weight,body mass index and body fat content,and may play an important role in lipid deposition in the liver of type 2 diabetic patients.

关 键 词：2型糖尿病 脂联素 胰岛素抵抗 脂肪肝 

分 类 号：R587.1[医药卫生—内分泌]