2型糖尿病病人外周血羧化不全骨钙素水平与合并非酒精性脂肪性肝病的关系分析  

Analysis of the relationship between peripheral blood undercarboxylated osteocalcin level and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

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 Yongxia;LIU Hongli(Department of Gastroenterology,Shijiazhuang Second Hospital,Shijiazhuang,Hebei 050051,China;Department of Traditional Chinese Medicine Diabetes,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10期2026-2030,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河北省医学科学研究重点课题计划项目(20201351)。

摘　　要：目的检测2型糖尿病(T2DM)病人羧化不全骨钙素(ucOC)浓度,并分析其与合并非酒精性脂肪性肝病(NAFLD)的关系。方法选取石家庄市第二医院2020年6月至2022年6月收治的234例T2DM病人设为疾病组,根据病人是否合并NAFLD分为NAFLD组(107例)和非NAFLD组(127例),同期选取231例健康体检者为对照组,采用酶联免疫吸附测定检测受试者外周血ucOC浓度。比较NAFLD组和非NAFLD组病人的临床资料,采用多因素logistic回归分析法分析T2DM病人合并NAFLD的影响因素,并绘制受试者操作特征曲线(ROC曲线)评价外周血ucOC浓度对T2DM合并NAFLD的诊断价值。结果疾病组外周血ucOC浓度[(1.10±0.42)μg/L]低于对照组[(1.53±0.68)μg/L](P<0.05);NAFLD组ucOC[(0.98±0.14)μg/L]低于非NAFLD组[(1.20±0.21)μg/L](P<0.05)。NAFLD组身体质量指数(BMI)、腰臀比以及空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、舒张压、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、尿酸、胰岛素抵抗指数(HOMA-IR)均高于非NAFLD组(P<0.05),高密度脂蛋白(HDL-C)低于非NAFLD组(P<0.05)。多因素结果显示,HbA1c、TG、尿酸及HOMA-IR升高均是T2DM病人合并NAFLD的危险因素(P<0.05),外周血ucOC浓度升高是其保护因素(P<0.05)。外周血ucOC浓度诊断T2DM病人合并NAFLD的最佳截断值、灵敏度、特异度、曲线下面积分别为1.05μg/L、83.18%、80.31%、0.84。结论T2DM病人外周血ucOC浓度降低,且合并NAFLD病人外周血ucOC浓度低于未合并病人。ucOC浓度与HbA1c、TG、尿酸、HOMA-IR均是T2DM病人合并NAFLD的影响因素,监测T2DM病人ucOC浓度变化有助于临床诊断NAFLD的发生。Objective To detect the concentration of uncarboxylated osteocalcin(ucOC)in patients with type 2 diabetes mellitus(T2DM),and to analyze its relationship with nonalcoholic fatty liver disease(NAFLD).Methods A total of 234 patients with T2DM admitted to Shijiazhuang Second Hospital from June 2020 to June 2022 were selected as the disease group,and they were further assigned into NAFLD group(107 cases)and non-NAFLD group(127 cases)according to whether the patients were complicated with NAFLD.At the same time,231 healthy subjects were selected as the control group.The concentration of ucOC in the peripheral blood of subjects was detected by enzyme-linked immunosorbent assay.The clinical data of patients in NAFLD group and non-NAFLD group were compared.Multivariate Logistic regression analysis was used to analyze the influencing factors of NAFLD in T2DM patients,and receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of ucOC concentration in peripheral blood for T2DM with NAFLD.Results The concentration of ucOC in peripheral blood of the disease group[(1.10±0.42)μg/L]was lower than that of the control group[(1.53±0.68)μg/L](P<0.05),and the ucOC in NAFLD group[(0.98±0.14)μg/L]was lower than that in non-NAFLD group[(1.20±0.21)μg/L](P<0.05).The levels of body mass index(BMI),waist-to-hip ratio,glycosylated hemoglobin(HbA1c),fasting insulin(FINS),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C),serum uric acid(UA)and insulin resistance index(HOMA-IR)in NAFLD group were higher than those in non-NAFLD group(P<0.05),while the levels of high density lipoprotein(HDL-C)was lower than that in non-NAFLD group(P<0.05).Multivariate results showed that elevated HbA1c,TG,UA level,and HOMA-IR were risk factors for NAFLD in T2DM patients(P<0.05),and the increase of ucOC concentration in peripheral blood was a protective factor(P<0.05).The optimal cut-off point,sensitivity,specificity and area under the curve of peripheral blood ucOC concentrat

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 羧化不全骨钙素 影响因素 受试者操作特征曲线 

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