血清簇集蛋白和1-磷酸鞘氨醇对2型糖尿病合并非酒精性脂肪性肝病的诊断价值分析  

Diagnostic Value of Serum Clusterin and Sphingosine 1-Phosphate Levels in Patients with Type 2 Diabetes Mellitus Complicated with Non-alcoholic Fatty Liver Disease

作　　者：赵永晓 王艳丽 苏江华[2] 王哲[3] 刘娜[1] ZHAO Yongxiao;WANG Yanli;SU Jianghua;WANG Zhe;LIU Na(Department of Gastroenterology,the Second Hospital of Shijiazhuang City,Shijiazhuang 050000,China;Department of Hospital Office,the Second Hospital of Shijiazhuang City,Shijiazhuang 050000,China;Department of Laboratory,the Second Hospital of Shijiazhuang City,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第二医院消化内科,石家庄050000 [2]石家庄市第二医院办公室,石家庄050000 [3]石家庄市第二医院检验科,石家庄050000

出　　处：《临床误诊误治》2025年第1期50-54,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点课题(20201349)。

摘　　要：目的探讨血清簇集蛋白、1-磷酸鞘氨醇(S1P)对2型糖尿病(T2DM)患者合并非酒精性脂肪性肝病(NAFLD)的诊断价值。方法对2020年12月至2022年12月收治的306例T2DM患者临床资料进行回顾性分析,将合并NAFLD患者179例设为研究组,将单纯T2DM患者127例设为对照组。检测2组患者血清簇集蛋白、S1P水平;采用受试者工作特性曲线评估二者对T2DM患者合并NAFLD的诊断价值;采用多因素logistic回归分析T2DM患者合并NAFLD的影响因素。结果研究组血清簇集蛋白水平高于对照组,血清S1P水平低于对照组(P<0.01)。血清簇集蛋白、S1P诊断T2DM合并NAFLD的曲线下面积(AUC)分别为0.749、0.854,二者联合诊断的AUC为0.904。血清簇集蛋白、血清S1P、体质量指数是T2DM患者合并NAFLD的影响因素(P<0.01)。结论血清簇集蛋白、S1P水平与T2DM患者合并NAFLD密切相关,可作为诊断T2DM患者合并NAFLD的潜在生物学指标。Objective To investigate the diagnostic value of serum clusterin and sphingosine 1-phosphate(S1P)levels in type 2 diabetes mellitus(T2DM)patients with non-alcoholic fatty liver disease(NAFLD).Methods Clinical data of 306 patients with T2DM admitted from December 2020 to December 2022 were retrospectively analyzed.Of them,179 patients with NAFLD were assigned as research group and 127 patients with T2DM alone were assigned as control group.Serum clusterin and S1P levels were detected.The diagnostic value of both indicators for NAFLD in T2DM patients was evaluated by receiver operating characteristic(ROC)curve.Multivariate logistic regression analysis was used to analyze the influencing factors of T2DM patients with NAFLD.Results The serum clusterin level of the research group was higher than that of the control group,while the serum S1P was lower than that of the control group(P<0.01).The area under the ROC curve(AUC)of serum tuftin and S1P in the diagnosis of T2DM with NAFLD was 0.749 and 0.854,respectively,and the AUC of the combined diagnosis was 0.904.Serum fascin,serum S1P and body mass index were the influential factors of NAFLD in T2DM patients(P<0.01).Conclusion The levels of serum clusterin and S1P are closely related to NAFLD in T2DM patients,and can be used as potential biological indicators of NAFLD in T2DM patients.

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 簇集蛋白 1-磷酸鞘氨醇 诊断价值 相关性 影响因素分析 

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