非酒精性脂肪性肝病合并2型糖尿病患者尿微量白蛋白及血清糖化血红蛋白和甲状腺激素水平变化  

Changes of urine microalbumin and serum thyroid hormones in patients with non-alcoholic fatty liver disease and concomitant type 2 diabetes mellitus

作　　者：吴彬彬 李丹丹 王子铭 Wu Binbin;Li Dandan;Wang Ziming(Clinical Laboratory,Taikang Xianlin Gulou Hospital Affiliated to Nanjing University School of Medicine,Nanjing 210023,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属泰康仙林鼓楼医院检验科,南京市210023

出　　处：《实用肝脏病杂志》2025年第2期210-213,共4页Journal of Practical Hepatology

基　　金：南京市卫健委卫生科技发展专项资金资助项目(编号:YKK22256)。

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)合并2型糖尿病(T2DM)患者尿微量白蛋白(U-mAl)及血清糖化血红蛋白(HbA1c)和甲状腺激素水平变化。方法2019年1月~2024年1月我院收治的T2DM患者91例和同期收治的NAFLD合并T2MD患者91例,使用全自动免疫分析仪检测血清促甲状腺素(TSH)、四碘甲状腺原氨酸(T4)和FT4水平,常规检测(U-mAl)及HbA1c和血清胰岛素(FINS)水平,计算HOMA-IR。结果NAFLD合并T2DM患者空腹血糖(FBG)、血清FINS、HOMA-IR和血清HbAlC水平分别为(7.6±1.0)mmol/L、(12.6±2.7)μIU/mL、(4.3±1.1)和(8.2±0.9)%,均显著高于T2DM患者【分别为(7.1±1.3)mmol/L、(9.4±3.1)μIU/mL、(3.0±1.3)和(7.0±1.2)%,P<0.05】;NAFLD合并T2DM患者U-mAl和血清T4水平分别为(71.6±10.1)mg/L和(134.7±16.6)nmol/L,显著高于T2DM患者【分别为(40.2±10.8)mg/L和(119.0±14.9)nmol/L,P<0.05】,而血清TSH和FT4水平分别为(2.1±0.7)mU/L和(12.4±1.7)pmol/L,均显著低于T2DM患者【分别为(3.5±0.7)mU/L和(16.8±3.0)pmol/L,P<0.05】;两组血脂水平无显著性差异(P>0.05)。结论NAFLD合并T2DM患者U-mAl和血清甲状腺素水平可能升高,提示临床处理的复杂性,需引起足够的重视。Objective The aim of this study was to investigate changes of urine microalbumin(U-mAl),serum hemoglobin Alc(HbA1c)and thyroid hormones in patients with non-alcoholic fatty liver disease(NAFLD)and concomitant type 2 diabetes mellitus(T2DM).Methods 91 patients with NAFLD and T2DM[non-alcoholic fatty liver(NAFL)in 56 cases,non-alcoholic steatohepatitis(NASH)in 23 cases and cirrhosis in 12 cases]and 91 patients with T2DM were encountered in our hospital between January 2019 and January 2024,serum thyroid stimulating hormone(TSH),tetraiodothyronine(T4)and FT4 levels were assayed by RIA,and fasting blood glucose(FBG),HbAlC,fasting insulin(FINS)and U-mAllevel were routinely detected.Results FBG,serum FINS,HOMA-IR and HbAlC levels in patients with NAFLD and T2DM were(7.6±1.0)mmol/L,(12.6±2.7)μIU/mL,(4.3±1.1)and(8.2±0.9)%,all much higher than[(7.1±1.3)mmol/L,(9.4±3.1)μIU/mL,(3.0±1.3)and(7.0±1.2)%,respectively,P<0.05]in patients with T2DM;U-mAl and serum T4 levels in patients with NAFLD and T2DMwere(71.6±10.1)mg/L and(134.7±16.6)nmol/L,both significantly higher than[(40.2±10.8)mg/L and(119.0±14.9)nmol/L,P<0.05],while serum TSH and FT4 were(2.1±0.7)mU/L and(12.4±1.7)pmol/L,both significantly lower than[(3.5±0.7)mU/L and(16.8±3.0)pmol/L,P<0.05]in patients with T2DM;there were no significant differences as respect to serum fat levels between the two groups(P>0.05).Conclusion U-mAl and serum thyroid hormone levels in patients with NAFLD and concomitant T2DM could elevate,which might sophisticate clinical management in this circumstances.

关 键 词：非酒精性脂肪性肝病 2型糖尿病 尿微量白蛋白 甲状腺激素 

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