血清ANGPTL4、THBS2与2型糖尿病合并非酒精性脂肪性肝病患者糖代谢及肝功能的相关性  

Correlation between serum ANGPTL4,THBS2,glucose metabolism,and liver function in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease

作　　者：李思锐 胥俊越[2] LI Sirui;XU Junyue(Department of Endocrinology,Beijing Electric Power Hospital,Beijing 100073,China;Department of Laboratory,Beijing Electric Power Hospital,Beijing 100073,China)

机构地区：[1]北京电力医院内分泌科,100073 [2]北京电力医院检验科,100073

出　　处：《国际消化病杂志》2024年第6期393-397,414,共6页International Journal of Digestive Diseases

摘　　要：目的 探究血清血管生成素样蛋白4(ANGPTL4)、血小板反应蛋白2(THBS2)与2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者糖代谢及肝功能的相关性。方法 选择2021年4月至2023年4月北京电力医院收治的95例T2DM合并NAFLD患者设为研究组,另选择同期该院收治的95例单纯性T2DM患者设为对照组。采用ELISA法检测2组的血清ANGPTL4、THBS2表达水平。采用Pearson相关分析探讨血清ANGPTL4、THBS2与T2DM合并NAFLD患者糖代谢和肝功能的相关性。采用多因素logistic回归分析探讨T2DM合并NAFLD的影响因素。采用ROC曲线分析血清ANGPTL4、THBS2表达水平诊断T2DM合并NAFLD的价值。结果 与对照组相比,研究组的胰岛素抵抗指数(Homa-IR)和三酰甘油(TG)、ALT、ANGPTL4及THBS2表达水平均显著升高(P均<0.05),高密度脂蛋白胆固醇(HDL-C)水平显著降低(P<0.05)。Pearson相关分析结果显示,T2DM合并NAFLD患者的血清ANGPTL4与Homa-IR、ALT均呈正相关(P均<0.05),血清THBS2与HOMA-IR、ALT也均呈正相关(P均<0.05)。多因素logistic回归分析结果显示,ANGPTL4、THBS2、TG、ALT、Homa-IR均是T2DM患者合并NAFLD的危险因素(P均<0.05),而HDL-C则是T2DM患者合并NAFLD的保护因素(P<0.05)。血清ANGPTL4、THBS2单独及联合检测诊断T2DM患者合并NAFLD的ROC曲线下面积(AUC)分别为0.778、0.807和0.897,2项联合检测的诊断价值分别高于单独检测(Z_(2项联合-ANGPTL4)=4.023,Z_(2项联合-THBS2)=3.957,P均<0.001)。结论 T2DM合并NAFLD患者的血清ANGPTL4、THBS2表达水平均升高,这2项指标与T2DM合并NAFLD患者的糖代谢和肝功能均密切相关。Objective This paper aims to explore the relationship between serum angiopoietin-like protein 4(ANGPTL4),thrombospondin-2(THBS2),glucose metabolism,and liver function in patients with type 2 diabetes mellitus(T2DM)and nonalcoholic fatty liver disease(NAFLD).Methods A total of 95 patients with T2DM and NAFLD,admitted to Beijing Electric Power Hospital between April 2021 and April 2023,were selected as the research group,and another 95 patients with simple T2DM,admitted to the hospital during the same period,were selected as the control group.ELISA was used to detect the expression levels of serum ANGPTL4 and THBS2 in both groups.Pearson correlation analysis was performed to explore the relationship between serum ANGPTL4,THBS2,glucose metabolism,and liver function in T2DM patients with NAFLD.Multivariate logistic regression analysis was used to explore the influencing factors of T2DM patients with NAFLD.The ROC curve was used to analyze the diagnostic value of serum ANGPTL4 and THBS2 in T2DM with NAFLD.Results Compared with the control group,the research group has significantly higher levels of HOMA-IR,triglycerides(TG),ALT,ANGPTL4,and THBS2(P<0.05),while the high-density lipoprotein cholesterol(HDL-C)level is significantly lower(P<0.05).Pearson correlation analysis reveals that serum ANGPTL4 is positively correlated with HOMA-IR and ALT in T2DM patients with NAFLD(P<0.05).Similarly,serum THBS2 is positively correlated with HOMA-IR and ALT level(P<0.05).Multivariate logistic regression analysis shows that ANGPTL4,THBS2,TG,ALT,and HOMA-IR are risk factors for T2DM patients with NAFLD(P<0.05),while HDL-C is a protective factor for T2DM patients with NAFLD(P<0.05).The ROC curve analysis shows that the area under the curve(AUC)for the diagnosis of T2DM with NAFLD using serum ANGPTL4 and THBS2 alone and in combination are 0.778,0.807,and 0.897,respectively.The combination of ANGPTL4 and THBS2 provides a higher diagnostic value than that of the detection of serum ANGPTL4 and THBS2 alone(Z_(combination-ANGPTL4)=4.023,Z_(c

关 键 词：血管生成素样蛋白4 血小板反应蛋白2 2型糖尿病 非酒精性脂肪性肝病 肝功能 

分 类 号：R575.5[医药卫生—消化系统] R587.1[医药卫生—内科学]