男性2型糖尿病合并代谢相关脂肪性肝病患者单核细胞/高密度脂蛋白胆固醇比值与胰岛素抵抗的相关性  

Correlation between monocyte to high-density lipoprotein cholesterol ratio and insulin resistance in male patients with type 2 diabetes mellitus combined with metabolic-related fatty liver disease

作　　者：钱方方[1] 李昊翔 沈怡蓉 喻夏雯 夏玥 王东[1] 杨玲[1] 贾珏[1] QIAN Fang-fang;LI Hao-xiang;SHEN Yi-rong;YU Xia-wen;XIA Yue;WANG Dong;YANG Ling;JIA Yu(Department of Endocrinology and Metabolism,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院内分泌代谢科,江苏镇江212001

出　　处：《中国热带医学》2023年第4期333-337,共5页China Tropical Medicine

基　　金：国家自然科学基金项目(No.81500351);江苏省青年医学重点人才项目(No.QNRC2016842)。

摘　　要：目的探讨男性2型糖尿病(type 2 diabetes mellitus,T2DM)合并代谢相关脂肪性肝病(metabolic-related fatty liver disease,MAFLD)患者单核细胞/高密度脂蛋白胆固醇比值(monocyte to high-density lipoprotein cholesterol ratio,MHR)与胰岛素抵抗(insulin resistance,IR)的相关性。方法选取2018年5月—2020年7月江苏大学附属医院就诊的454例男性T2DM合并MAFLD患者为研究对象。收集一般临床资料、检测血常规和生化指标,计算稳态模型胰岛素抵抗指数(homeostasis model insulin resistance index,HOMA-IR),测定患者内脏脂肪面积(visceral fat area,VFA)及皮下脂肪面积(subcutaneous fat area,SFA)。按MHR四分位分为Q1组(MHR≤0.38)、Q2组(0.380.64),比较4组各指标及胰岛素抵抗的差异。按HOMA-IR将患者分为HOMA-IR<2.5组和HOMA-IR≥2.5组,比较两组MHR的差异。结果Q1、Q2、Q3和Q4组分别为115、110、120和10^(9)例,各组患者空腹胰岛素(fasting insulin,FINS)分别为6.17(4.20,9.76)、7.73(4.94,10.66)、8.92(5.32,11.33)和9.13(5.25,12.27)mU/L,餐后2 h胰岛素(2hour postprandial insulin,2hINS)分别为22.75(12.87,39.59)、27.55(16.44,39.77)、30.98(17.46,43.11)和31.28(18.54,45.92)U/L,HOMA-IR分别为3.12(1.63,4.25)、3.72(2.26,4.66)、3.87(2.48,5.44)和3.95(2.42,5.31),中性粒细胞计数(Neutrophil,Neu)分别为3.10(2.60,3.70)、3.20(2.50,3.93)、3.60(2.80,4.28)、4.20(3.30,5.00)×10^(9)/L,SFA分别为(181.27±53.60)、(192.64±62.41)、(199.53±61.40)和(203.69±71.51)cm^(2),随着MHR的升高,FINS、2hINS、HOMA-IR、Neu和SFA均逐渐增高,而高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-c)分别为1.18(1.06,1.35)、1.02(0.86,1.17)、0.96(0.80,1.03)和0.80(0.69,0.92)mmol/L及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDLc)分别为(3.00±0.79)、(2.76±0.83)、(2.67±0.85)和(2.59±0.92)mmol/L逐渐下降,差异有统计学意义(P<0.05)。Pearson或Spearman相关分析,MHR与FINS、2hINS、HOMA-IR、VFA、SFA呈正相关(r=0.190、0.153、0.184、Objective To explore the correlation between monocyte to high-density lipoprotein cholesterol ratio(MHR)and insulin resistance(IR)in male patients with type 2 diabetes mellitus(T2DM)combined with metabolic-related fatty liver disease(MAFLD).Methods A total of 454 male patients with T2DM combined with MAFLD in National Metabolic Management Center(MMC)of the Affiliated Hospital of Jiangsu University from May 2018 to July 2020 were enrolled.The general clinical data of subjects were collected,blood routine and biochemical indexes were tested,homeostasis model insulin resistance index(HOMA-IR)was calculated,visceral fat area(VFA)and subcutaneous fat area(SFA)were measured.Accordingtothe MHR quartile,patients were divided into group Q1(MHR≤0.38),group Q2(0.38<MHR≤0.48),group Q3(0.48<MHR≤0.64)and group Q4(MHR>0.64)to compare the differences in measured indicators above.In addition,patients were divided into two groups according to HOMA-IR,HOMA-IR<2.5 and HOMA-IR≥2.5,and the differences in MHR were compared.Results The patients were divided into four groups according to MHR:group Q1(n=115),group Q2(n=110),group Q3(n=120)and group Q4(n=10^(9)).Fasting insulin(FINS)were respectively 6.17(4.20,9.76),7.73(4.94,10.66),8.92(5.32,11.33)and 9.13(5.25,12.27)mU/L,2-hour postprandial insulin were 22.75(12.87,39.59),27.55(16.44,39.77),30.98(17.46,43.11)and 31.28(18.54,45.92)U/L.HOMA-IR were 3.12(1.63,4.25),3.72(2.26,4.66),3.87(2.48,5.44)and 3.95(2.42,5.31).Neutrophil(Neu)were 3.10(2.60,3.70),3.20(2.50,3.93),3.60(2.80,4.28),4.20(3.30,5.00)×10^(9)/L.Subcutaneous fat area(SFA)were(181.27±53.60),(192.64±62.41),(199.53±61.40)and(203.69±71.51)cm^(2).They all increased gradually.However,the levels of high-density lipoprotein cholesterol(HDL-c)[1.18(1.06,1.35),1.02(0.86,1.17),0.96(0.80,1.03)and 0.80(0.69,0.92)mmol/L]and low-density lipoprotein cholesterol(LDL-c)[(3.00±0.79),(2.76±0.83),(2.67±0.85)and(2.59±0.92)mmol/L]decreased gradually.Pearson's or Spearman's correlation analysis showed that MHR was positively correlated

关 键 词：糖尿病 代谢相关脂肪性肝病 中性粒细胞/高密度脂蛋白胆固醇比值 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]