2型糖尿病患者血清质膜膜泡关联蛋白水平与代谢相关脂肪性肝病相关性的研究  

Correlation between serum PLVAP levels and metabolism?related fatty liver disease in patients with type 2 diabetes mellitus

作　　者：王蓉蓉[1] 王玉慧 姚统瀚 刘静[2] 戴思孟 常昕颖 余静 仇菊梅 张琦[2] WANG Rongrong;WANG Yuhui;YAO Tonghan(The First Clinical College,Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]甘肃省人民医院老年医学科 [3]甘肃省人民医院内分泌科

出　　处：《中国糖尿病杂志》2024年第12期881-885,共5页Chinese Journal of Diabetes

基　　金：国家自然科学基金(82160166,81960173);甘肃省重点研发计划(22YF7FA096);甘肃省人民医院院内科研基金(22GSSYA-1);兰州市人才创新创业项目(2021-RC-136);兰州市卫生健康委科技发展项目(2021005);甜蜜医生培育项目(2021SD01)。

摘　　要：目的探讨T2DM患者血清质膜膜泡关联蛋白(PLVAP)水平与代谢相关脂肪性肝病(MAFLD)的相关性。方法选取2023年9月至2024年3月甘肃省人民医院就诊的T2DM患者255例,根据是否合并MAFLD分为单纯T2DM组(n=141)和合并MAFLD组(MAFLD,n=114)。Spearman相关分析血清PLVAP与其他指标的相关性,多元线性回归分析血清PLVAP的影响因素,Logistic回归分析T2DM患者发生MAFLD的影响因素。受试者工作特征(ROC)曲线分析血清PLVAP对T2DM患者MAFLD的早期诊断价值。结果与T2DM组比较,MAFLD组BMI、WC、FPG、C-P、HOMA-IR、TG、谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)、肝脂肪变性指数(HSI)、植物血凝素样氧化型低密度脂蛋白受体1(LOX-1)升高(P<0.05),DM病程、HDL-C、AST/ALT、PLVAP降低(P<0.05)。Spearman相关分析显示,PLVAP与AST/ALT呈正相关(P<0.05),与WC、DBP、C-P、ALT、GGT、HSI呈负相关(P<0.05)。多元线性回归分析显示,WC是PLVAP的影响因素。Logistic回归分析显示,DM病程、WC、TG、PLVAP、LOX-1是MAFLD的影响因素。ROC曲线分析显示,PLVAP诊断T2DM患者合并MAFLD的曲线下面积为0.785,敏感度为81.6%,特异度为67.4%。结论PLVAP降低是T2DM患者合并MAFLD的危险因素,对预测T2DM患者合并MAFLD具有重要意义。Objective To investigate the correlation between serum plasma membrane vesicle-associated protein(PLVAP)levels and metabolism-associated fatty liver disease(MAFLD)in patients with T2DM.Methods Atotal of 255 patients with type 2 diabetes mellitus(T2DM)went to Gansu Provincial Hospital from September 2023 to March 2024 were selected in this study,and were divided into T2DM alone group(n=141)and the T2DM combined with MAFLD group(n=114)according to whether they were combined with MAFLD or not.Spearman correlation analysis was used to analyze the correlation between serum PLVAP and other indexes,multiple linear regression analysis was used to analyze the influencing factors of serum PLVAP,and Logistic regression analysis was used to analyze the influencing factors of MAFLD in T2DM patients.The early diagnostic value of serum PLVAP on MAFLD in patients with T2DM by analyzing the receiver's operating characteristics(ROC)curve.Results Compared with the MAFLD group,BMI,WC,FPG,C-P,HOMA-IR,TG,AST,ALT,GGT,hepatic steatosis index(HSI)and phytohaemagglutinin-like oxidized low-density lipoprotein receptor 1(LOX-1)were decreased in the T2DM group(P<0.05).DM duration,HDL-C,AST/ALT and PLVAP were elevated(P<0.05).Spearman correlation analysis showed that PLVAP was positively correlated with AST/ALT(P<0.05)and negatively correlated with WC,DBP,C-P,ALT,GGT and HSI(P<0.05).Multiple linear regression analysis showed that WC was an influencing factor for PLVAP.Logistic regression analysis showed that DM duration,WC,TG,PLVAP,LOX-1 were influencing factors for MAFLD.Analysis of the subjects'work characteristics(ROC)curve showed that the area under the ROC curve was 0.785,with a sensitivity of 81.6%and a specificity of 67.4%.Conclusions Reduced PLVAP is a risk factor for comorbid MAFLD in patients with T2DM and is important for predicting the co-existence of MAFLD in patients with T2DM.

关 键 词：糖尿病 2型 代谢相关脂肪性肝病 质膜膜泡关联蛋白 植物血凝素样氧化型低密度脂蛋白受体1 

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