血清CXC趋化因子配体17与2型糖尿病合并非酒精性脂肪性肝病的相关性研究  

Association between serum CXC chemokine ligand 17 and type 2 diabetes mellitus with non-alcoholic fatty liver disease

作　　者：朱燕[1] 胡竞成 吴梦娇[1] 杜宣[1] 李慧娟[1] 施毕旻[1] Zhu Yan;Hu Jingcheng;Wu Mengjiao;Du Xuan;Li Huijuan;Shi Bimin(Department of Endocrinology,First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院内分泌科,苏州215000

出　　处：《中华糖尿病杂志》2024年第2期214-219,共6页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的探讨血清CXC趋化因子配体17(CXCL17)与2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的相关性。方法为横断面研究。选取2021年4月至2022年12月在苏州大学附属第一医院内分泌科住院的新诊断T2DM患者及同时期该院体检中心糖耐量正常的健康体检者(对照组)作为研究对象。收集研究对象身高、体重并计算体重指数(BMI),检测其CXCL17、低密度脂蛋白胆固醇(LDL-C)、丙氨酸转氨酶(ALT),测量其肝脏脂肪分数(HFF)。根据HFF结果,将T2DM患者分为单纯T2DM组(HFF≤5.5%)和T2DM合并NAFLD组(HFF>5.5%)。采用单因素方差分析、Kruskal-WallisH检验、χ^(2)检验进行组间比较,采用Spearman相关性分析法分析HFF与其他指标的相关性,采用二元logistic回归分析法分析T2DM患者合并NAFLD的独立影响因素。结果共纳入270例研究对象,其中,对照组90名,单纯T2DM组88例,T2DM合并NAFLD组92例。T2DM合并NAFLD组的血清CXCL17浓度[(95.62±6.83)ng/L]高于单纯T2DM组[(56.49±9.45)ng/L]和对照组[(21.59±5.12)ng/L](均P<0.05)。Spearman相关性分析法结果显示,T2DM患者的HFF与血清CXCL17(r=0.672)、BMI(r=0.481)、ALT(r=0.447)、LDL-C(r=0.253)均呈正相关(均P<0.001)。二元logistic回归分析结果显示,血清CXCL17(OR=0.949,95%CI 0.926~0.973)、BMI(OR=0.773,95%CI 0.678~0.882)、ALT(OR=0.943,95%CI 0.918~0.968)、LDL-C(OR=0.632,95%CI 0.432~0.923)是T2DM患者合并NAFLD的独立影响因素(P<0.05)。结论血清CXCL17增高是T2DM患者发生NAFLD的独立影响因素。Objective To investigate the association between the serum CXC chemokine ligand 17(CXCL17)and type 2 diabetes mellitus(T2DM)with non-alcoholic fatty liver disease(NAFLD).Methods This was a cross-sectional study.Newly diagnosed T2DM patients hospitalized at the Department of Endocrinology of the First Affiliated Hospital of Soochow University from April 2021 to December 2022 and the healthy volunteers in the physical examination center during the same period were selected as the control group.Height and weight of the participants were collected,body mass index(BMI)was calculated,CXCL17,low-density lipoprotein-cholesterol(LDL-C)and glutamic pyruvic transaminase(ALT)were detected,and hepatic fat fraction(HFF)was measured.According to HFF,patients with T2DM but without NAFLD were assigned to T2DM group(HFF≤5.5%),and patients with T2DM and NAFLD were assigned to T2DM+NAFLD group(HFF>5.5%).One-way analysis of variance(ANOVA),Kruskal-Wallis H test and χ^(2) test were used for comparisons between groups,Spearman correlation analysis was used to analyze the correlation between HFF and other variables,and binary logistic regression analysis was used to analyze the independent influencing factors of T2DM patients with NAFLD.Results Two hundred and seventy patients were enrolled.Of these,88 were in T2DM group,92 in T2DM+NAFLD group and 90 in control group.The level of serum CXCL17 in T2DM+NAFLD group[(95.62±6.83)ng/L]was higher than that in T2DM group[(56.49±9.45)ng/L]and control group[(21.59±5.12)ng/L](P<0.05).Spearman correlation analysis showed that HFF was positively correlated with CXCL17(r=0.672),BMI(r=0.481),ALT(r=0.447),LDL-C(r=0.253),respectively(all P<0.001).Binary logistic regression showed that CXCL17(OR=0.949,95%CI 0.926-0.973),BMI(OR=0.773,95%CI 0.678-0.882),ALT(OR=0.943,95%CI 0.918-0.968),LDL-C(OR=0.632,95%CI 0.432-0.923)were independent influencing factors of NAFLD(P<0.05).Conclusion The increase of serum CXCL17 might be an independent risk factor of NAFLD.

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 CXC趋化因子配体17 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]