2型糖尿病患者胰岛素样生长因子-1与丙氨酸转移酶的相关性研究  

Association between insulin growth factor-1 and alanine aminotransferase in patients with type 2 diabetes mellitus

作　　者：刘芳 赵强 王雅儒 张梅[2] 班博[2] Liu Fang;Zhao Qiang;Wang Yaru;Zhang Mei;Ban Bo(Department of Clinical Medicine,Jining Medical University,Jining 272000,China;Department of Endocrinology,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院临床医学院,山东济宁272000 [2]济宁医学院附属医院内分泌科,山东济宁272029

出　　处：《中国临床实用医学》2021年第5期21-25,共5页China Clinical Practical Medicine

基　　金：山东省自然科学基金(ZR2018PH009)。

摘　　要：目的探讨2型糖尿病(T2DM)患者胰岛素生长因子-1(IGF-1)与丙氨酸转氨酶(ALT)的相关性。方法选取2017年7月至2019年5月济宁医学院附属医院内分泌科收治住院的808例T2DM患者,男370例,女438例,年龄(54.36±12.12)岁,年龄范围为18~87岁。收集其一般资料和生化指标,分析T2DM患者IGF-1与ALT的相关性。结果所有患者IGF-1水平为(157.51±62.53)μg/L,ALT水平为(20.60±14.31)U/L。按照IGF-1水平四分位数分为四组,随着IGF-1的升高,ALT呈现先降低后升高的趋势,性别、年龄、病程、IGF-1、ALT、高密度脂蛋白胆固醇(HDL-C)、肌酐、尿酸在四组中比较,差异均有统计学意义(P<0.05)。患者临床资料与ALT的单因素分析显示体质量指数、空腹血糖与ALT呈正相关(P<0.05),年龄、病程、IGF-1、HDL-C、尿酸与ALT呈负相关(P<0.05),腰臀比、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、肌酐、糖化血红蛋白(HbA1c)与ALT无相关性(P>0.05)。通过平滑曲线拟合分析IGF-1与ALT的相关性,IGF-1与ALT呈曲线关系,存在一个拐点,为156μg/L,当IGF-1<156μg/L时,IGF-1每增加1μg/L,ALT降低0.08 U/L(P=0.0009);当IGF-1≥156μg/L时,IGF-1每增加1μg/L,ALT增加0.02 U/L(P=0.2411)。结论在T2DM患者中,IGF-1水平与ALT水平之间存在非线性关系。当IGF-1水平达到拐点时,IGF-1水平与ALT水平呈正相关,这一关系及其机制有待进一步研究。Objective To investigate the association between insulin-like growth factor-1(IGF-1)and alanine aminotransferase(ALT)in type 2 diabetes mellitus(T2DM).Methods A total of 808 inpatients with T2DM were selected from the department of Endocrinology,Affiliated Hospital of Jining Medical College from July 2017 to May 2019,with 370 males and 438 females,aged(54.36±12.12)years old,ranging from 18 to 87 years old,Collect their general data and biochemical indicators to analyze the correlation between IGF-1 and ALT in patients with T2DM.Results All patients had IGF-1 levels of(157.51±62.53)μg/L and ALT levels of(20.60±14.31)U/L.IGF-1 was divided into four groups according to the quartile,and among the four groups,there were significant differences in gender,age,course of disease,IGF-1,ALT,high density lipoprotein cholesterol(HDL-C),creatinine and uric acid(P<0.05).With the increase of IGF-1,ALT decreased first and then increased.Univariate analysis of clinical data and ALT showed that women had higher ALT levels than men,ang body mass index and fasting blood glucose positively correlated with ALT(P<0.05),while age,disease course,IGF-1,HDL-C and uric acid negatively correlated with ALT(P<0.05).Waist-to-hip ratio,total cholesterol,triglycerides,low density lipoprotein cholesterol(LDL-C),creatinine and glycared hemoglobin(HbA1c)had no correlation with ALT(P>0.05).The correlation between IGF-1 and ALT was analyzed by smooth curve fitting.IGF-1 and ALT presented a curve relationship with an inflection point of 156μg/L.When IGF-1 was less than 156μg/L,for every 1μg/L increase in IGF-1,ALT decreased by 0.08 U/L(P=0.0009).When IGF-1≥156μg/L,for every 1μg/L increase in IGF-1,ALT increased by 0.02 U/L(P=0.2411).Conclusion This study has shown a nonlinear relationship between IGF-1 levels and ALT levels in patients with T2DM.When IGF-1 level reached the inflection point,IGF-1 level positively correlated with ALT level.This relationship and its mechanism need to be further studied.

关 键 词：代谢相关脂肪性肝病 2型糖尿病 胰岛素样生长因子-1 丙氨酸转移酶 

分 类 号：R587.1[医药卫生—内分泌]