血清可溶性CD36、抵抗素、能量平衡相关蛋白联合预测2型糖尿病合并非酒精性脂肪性肝病的价值探讨  

The value of serum soluble CD36,resistin,and energy balance-related protein in combination to predict type 2 diabetes mellitus combined with nonalcoholic fatty liver disease

作　　者：孟令华[1] 位庚[2] 常湛[2] 赵永晓 刘红利 MENG Linghua;WEI Geng;CHANG Zhan;ZHAO Yongxiao;LIU Hongli(Department of Gastroenterology,Shijiazhuang Second Hospital,Shijiazhuang,Hebei 050051,China;Diabetes Department of Traditional Chinese Medicine,Shijiazhuang Second Hospital,Shijiazhuang,Hebei 050051,China)

机构地区：[1]石家庄市第二医院消化内科,河北石家庄050051 [2]石家庄市第二医院糖尿病中医科,河北石家庄050051

出　　处：《安徽医药》2024年第6期1165-1169,共5页Anhui Medical and Pharmaceutical Journal

基　　金：2020年度河北省医学科学研究重点课题计划项目(20201351)。

摘　　要：目的探讨血清可溶性CD36(sCD36)、抵抗素、能量平衡相关蛋白(Adropin)联合对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的预测价值。方法前瞻性选取石家庄市第二医院2018年5月至2021年5月收治的90例T2DM合并NAFLD病人(A组)、90例单纯T2DM病人(B组),同期选取90例体检健康者(对照组)作为研究对象。通过酶联免疫吸附测定检测研究对象血清sCD36、抵抗素、Adropin表达水平,对比分析三组sCD36、抵抗素、Adropin表达水平差异;分析sCD36、抵抗素、Adropin表达相关性;logistic回归分析T2DM合并NAFLD的影响因素;受试者操作特征曲线(ROC曲线)分析sCD36、抵抗素、Adropin三者联合对T2DM合并NAFLD的预测价值。结果A组病人血清sCD36(63.7±15.6)ng/L、抵抗素(3.15±0.46)μg/L水平均高于B组[(43.8±14.2)ng/L、(2.72±0.68)μg/L]和对照组[(22.9±5.7)ng/L、(2.58±0.39)μg/L](P<0.05),血清Adropin水平(66.28±27.62)ng/L均低于B组(86.73±25.46)ng/L和对照组(128.59±45.22)ng/L,差异有统计学意义(P<0.05)。sCD36与抵抗素表达水平呈正相关(r=0.29,P<0.05),Adropin与sCD36表达呈负相关(r=−0.57,P<0.05)。logistic回归分析显示,sCD36,抵抗素,总胆固醇(TC)是T2DM合并NAFLD的影响因素(P<0.05)。ROC曲线分析显示,sCD36、抵抗素、Adropin单独及三者联合预测T2DM合并NAFLD的曲线下面积(AUC)分别为0.81、0.74、0.72、0.89,三者联合对T2DM合并NAFLD的预测效能显著高于单指标独立预测(P<0.05)。结论T2DM合并NAFLD病人血清sCD36、抵抗素水平升高,Adropin水平降低,三者联合对预测T2DM合并NAFLD具有较高效能。Objective To investigate the predictive value of serum soluble CD36(sCD36),resistin,and energy balance-associated protein(Adropin)combined with type 2 diabetes mellitus(T2DM)in patients with nonalcoholic fatty liver disease(NAFLD).Methods A total of 90 patients with T2DM and NAFLD(group A)and 90 patients with T2DM alone(group B)admitted to the Second Hospital of Shijiazhuang City from May 2018 to May 2021 were prospectively selected,and 90 physically examined healthy people(control group)were selected as study subjects during the same period.The serum sCD36,resistin and adropin expression levels of the study subjects were detected by enzyme-linked immunosorbent assay,and the differences in the expression levels of sCD36,resistin and adropin among the three groups were compared and analyzed.The correlations between the expression of sCD36,resistin and adropin were analyzed;logistic regression was used to analyze the influencing the combination of T2DM and NAFLD;and the receiver operating characteristic(ROC)curves were used to analyze the predictive value of the combination of sCD36,resistin and adropin on the prognosis of patients with T2DM combined with NAFLD.Results The serum levels of sCD36(63.7±15.6)ng/L and resistin(3.15±0.46)μg/L were greater in patients in group A than in the group B[(43.8±14.2)ng/L,(2.72±0.68)μg/L]and in the control group[(22.9±5.7)ng/L,(2.58±0.39)μg/L](P<0.05).The serum adropin concentration[(66.28±27.62)ng/L]was significantly lower than that in group B[(86.73±25.46)ng/L]and the control group[(128.59±45.22)ng/L],and the differences were statistically significant(P<0.05).sCD36 was positively correlated with the expression level of resistin(r=0.29,P<0.05),and adropin was negatively correlated with the expression of sCD36(r=−0.57,P<0.05).Logistic regression analysis revealed that sCD36,resistin,and total cholesterol(TC)influenced T2DM combined with NAFLD ROC curve analysis revealed that the areas under the curve(AUCs)of sCD36,resistin,and Adropin alone and in combination with T

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 可溶性CD36 抵抗素 能量平衡相关蛋白 

分 类 号：R587.2[医药卫生—内分泌] R575.5[医药卫生—内科学]