血清脂肪分化相关蛋白水平与2型糖尿病合并非酒精性脂肪肝的相关性  

Association between serum adipose differentiation-related protein and nonalcoholic fatty liver disease in type 2 diabetes mellitus

作　　者：樊华英[1] 刁红杰 成兴波[1] 鲁燕[1] 范庆涛[1] Fan Huaying;Diao Hongjie;Cheng Xingbo;Lu Yan;Fan Qingtao(Department of Endocrinology,The First Affiliated Hospital of Soochow University,Suzhou 215006,China;The Health Service Center of Suzhou Xietang Community,Suzhou 215100,China)

机构地区：[1]苏州大学附属第一医院内分泌科,215006 [2]苏州斜塘社区卫生服务中心,215100

出　　处：《中华糖尿病杂志》2019年第12期799-802,共4页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：苏州市科技项目(SYS201603)。

摘　　要：目的探讨血清脂肪分化相关蛋白(ADRP)与2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的相关性。方法选取2016年1至10月苏州大学附属第一医院内分泌科住院的102例T2DM患者为研究对象,按是否合并NAFLD分为T2DM+NAFLD组(52例)和T2DM+Non-NAFLD组(50例),另选同期门诊健康体检者为对照组(NC组,40名),收集一般临床资料,ELISA法检测血清ADRP浓度,同时测定代谢相关指标及肝酶水平,稳态模型评估胰岛素抵抗指数(HOMA-IR)。采用卡方检验、方差分析、SNK检验、多元线性逐步回归分析、Logistic回归分析进行统计学处理。结果NC组、T2DM+Non-NAFLD组、T2DM+NAFLD组3组血清ADRP浓度依次升高,各组间差异均有统计学意义[分别为(2.98±0.42)、(3.68±0.56)、(4.85±0.45)μg/L,均P<0.05]。多元线性逐步回归分析显示年龄、腰围(WC)、糖化血红蛋白、HOMA-IR、甘油三酯(TG)是血清ADRP的独立影响因素(β=0.007、0.016、0.109、0.235、0.268,均P<0.05)。Logistic回归分析显示,ADRP、WC、TG是T2DM合并NFALD的独立危险因素(OR=5.916、3.500、3.513,均P<0.05)。结论血清ADRP升高是T2DM合并NFALD的危险因素,且与年龄、肥胖、胰岛素抵抗、高血糖、高血脂密切相关,可能在糖尿病和NAFLD疾病的发生发展中起一定作用。Objective To investigate the relationship between serum adipose differentiation-related protein(ADRP)and nonalcoholic fatty liver disease(NAFLD)in type 2 diabetes mellitus(T2DM).Methods This study enrolled 102 patients with T2DM hospitalized in the Department of Endocrinology,the First Affiliated Hospital of Soochow University,between January and October in 2016.The patients were divided into T2DM+NAFLD group(n=52)and T2DM+non-NAFLD group(n=50)according to the presence of NAFLD.In addition,healthy individuals were selected as control group(NC,n=40).The general clinical data were collected.Serum ADRP concentrations were measured with ELISA.Routine metabolic parameters and liver enzymes were also collected.Insulin resistance index was calculated by homeostasis model assessment of insulin resistance(HOMA-IR).Data were analyzed using Chi-Square Test,one-way ANOVA,SNK test,multivariate linear regression analysis and binary logistic regression analysis.Results Serum ADRP levels in NC group,T2DM+Non-NAFLD group and T2DM+NAFLD group showed an increasing trend[(2.98±0.42),(3.68±0.56),(4.85±0.45)μg/L,all P<0.05].The between-group differences had statistical significance(P<0.01).Multivariate linear regression analysis showed that ADRP was independently correlated with age,waist circumference(WC),glycosylated hemoglobin(HbA1c),HOMA-IR and triglyceride(TG)(β=0.007,0.016,0.109,0.235,0.268,all P<0.05).Binary Logistic regression analysis showed that ADRP,WC and TG were the independently risk factors for NAFLD with T2DM(OR=5.916,3.500,3.513,all P<0.05).Conclusions Increased serum ADRP level acts as an independent risk factor for NAFLD with T2DM.The ADRP level is closely related to age,obesity,insulin resistance,hyperglycemia and hyperlipemia.ADRP may play a role in the pathogenesis and development of diabetes and NAFLD.

关 键 词：糖尿病 2型 脂肪肝 非酒精性 胰岛素抵抗 脂肪分化相关蛋白 

分 类 号：R575[医药卫生—消化系统] R587[医药卫生—内科学]