2型糖尿病合并NAFLD患者FA水平及代谢指标的相关性研究`  

Correlational between Fetuin-A and Metabolic Indicators in Patients with Type 2 Diabetes Complicated with NAFLD

作　　者：潘晓洁[1] 斯徐伟[1] 尤巧英[1] 楼大钧[1] 黄迪华[1] Pan Xiaojie;Si Xuwei;You Qiaoying(Department of Endocrinology,Shaoxing People′s Hospital,Zhejiang 312000,China)

机构地区：[1]绍兴市人民医院内分泌代谢科,312000

出　　处：《医学研究杂志》2021年第5期80-83,共4页Journal of Medical Research

基　　金：浙江省绍兴市公益性技术应用研究计划项目(2017B70028)。

摘　　要：目的探讨2型糖尿病(type2 diabetes,T2DM)合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者中血清胎球蛋白A(fetuin A,FA)的水平及其与胰岛功能、代谢指标的相关性。方法选择笔者医院的T2DM患者170例,根据B超将其分为不伴NAFLD组(T2DM1),伴NAFLD组(T2DM2)。同时选取40例笔者医院健康体检者为对照组(NC组)。记录受试者基本信息、糖尿病病程、高血压病史、体重、腰围、BMI等;检测血清FA、空腹血糖、空腹胰岛素、糖化血红蛋白、生化指标等,计算HOMA-IR、HOMA-β。通过Pearson或Spearman相关性分析及多重线性逐步回归探讨T2DM合并NAFLD患者FA的影响因素。Logistic分析筛查T2DM患者NAFLD的危险因素。结果3组间FA水平从高到低依次为T2DM2>T2DM1>NC组(721.83±138.59,657.31±155.99,534.26±160.12mg/L,P均<0.05)。T2DM2组其腰围、体重、BMI、空腹胰岛素、ALT、AST、GGT、ALP、血尿酸、TG、HOMA-IR、HOMA-β均高于T2DM1组(P均<0.05)。在T2DM患者中血清FA与糖尿病病程呈负相关(β=-4.881,P<0.05),与NAFLD呈正相关(β=52.459,P<0.05)。Logistic回归分析显示BMI、TG、GGT是T2DM患者NAFLD发病的独立危险因素。结论T2DM合并NAFLD患者具有更严重的代谢问题,FA可能通过胰岛素抵抗参与T2DM患者NAFLD的形成,BMI、TG、GGT是T2DM患者NAFLD发病的独立危险因素。Objective To investigate the level of fetuin A in type 2 diabetes(T2DM)patients with non-alcoholic fatty liver disease(NAFLD),and the correlation between fetuin-A and islet function and metabolic indicators.Methods A total of 170 patients with T2DM were recruited as subjects.By ultrasonography,they were divided into two groups as:T2DM without NAFLD group(T2DM1),T2DM with NAFLD group(T2DM2).40 subjects from the medical examination center were selected as normal control group(NC).Data including gender,age,diabetes duration,hypertension history,waist circumference,BMI,blood pressure were recorded,and clinical biochemical parameters including fasting plasma glucose,fasting insulin,glycated hemoglobin A1c,lipid profile,CRP,uric acid,and liver enzymes were assessed,HOMA-IR and HOMA-βwere calculated.Pearson or Spearman correlation analysis and multiple stepwise regression analysis were used to explore the influencing factors of fetuin-A in patients with T2DM complicated with NAFLD.The risk factor screening of NAFLD was used Logistic regression analysis.Results The serum fetuin-A level of T2DMgroup was higher than NC group.The order of serum fetuin-A from high to low was T2DM2,T2DM1,NC(721.83±138.59,657.31±155.99,534.26±160.12mg/L,all P<0.05).WC,body weight,BMI,FINS,ALT,AST,GGT,ALP,Uric acid,TG,HOMA-IR and HOMA-βin the T2DM2 group were all higher than those in T2DM1 group(all P<0.05).Serum FA was negatively associated with diabetes duration,and positively associated with NAFLD.Logistic regression analysis showed that BMI,TG,GGT were independent risk factors of NAFLD in T2DM patients.Conclusion T2DM patients with NAFLD combined with more serious metabolic promblems.FA may be related to the development and progression of NAFLD through IR in T2DM.BMI,TG,GGT were independent risk factors of NAFLD in T2DM patients.

关 键 词：2型糖尿病 血清胎球蛋白A 非酒精性脂肪性肝病 胰岛素抵抗 

分 类 号：R587[医药卫生—内分泌]