CAJ | 학술논문

目的：探讨2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）患者血浆嗜铬蛋白A（CHGA）与脂肪组织三酰甘油脂肪酶（ATGL）的相关性。方法采用酶联免疫吸附法检测T2DM合并NAFLD组（A组，74例）、T2DM不合并NAFLD组（B组，76例）和正常对照组（NC组，75例）血浆CHGA和ATGL水平，分析各代谢指标与CHGA、ATGL的相关性，回归分析T2DM合并NAFLD的影响因素。结果血浆CHGA（μg/L）水平在A组（83.15±9.46）、B组（70.90±2.75）均高于NC组（46.74±8.15），A组高于B组（均P<0.01）。血浆ATGL（μg/L）水平在A组（21.36±13.42）、B组（40.29±22.83）均低于NC组（72.30±26.41），A组低于B组（均P<0.01）。在A组患者中，血浆CHGA与ATGL、碳水化合物氧化率呈负相关，与空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、游离脂肪酸（FFA）、脂肪氧化率呈正相关；血浆ATGL水平与体质指数（BMI）、FINS、胆固醇（TC）、三酰甘油（TG）、HOMA-IR呈负相关，与FFA呈正相关。多元逐步线性回归分析显示：FINS、ATGL、FFA是影响CHGA水平的因素。Logistic回归分析显示：CHGA、ATGL、FFA水平是T2DM合并NAFLD的影响因素。结论血浆CHGA和ATGL与糖脂、能量代谢密切相关，且两者可能通过相互作用影响T2DM合并NAFLD的发生发展。
목적：탐토2형당뇨병（T2DM）합병비주정성지방간（NAFLD）환자혈장기락단백A（CHGA）여지방조직삼선감유지방매（ATGL）적상관성。방법채용매련면역흡부법검측T2DM합병NAFLD조（A조，74례）、T2DM불합병NAFLD조（B조，76례）화정상대조조（NC조，75례）혈장CHGA화ATGL수평，분석각대사지표여CHGA、ATGL적상관성，회귀분석T2DM합병NAFLD적영향인소。결과혈장CHGA（μg/L）수평재A조（83.15±9.46）、B조（70.90±2.75）균고우NC조（46.74±8.15），A조고우B조（균P<0.01）。혈장ATGL（μg/L）수평재A조（21.36±13.42）、B조（40.29±22.83）균저우NC조（72.30±26.41），A조저우B조（균P<0.01）。재A조환자중，혈장CHGA여ATGL、탄수화합물양화솔정부상관，여공복이도소（FINS）、이도소저항지수（HOMA-IR）、유리지방산（FFA）、지방양화솔정정상관；혈장ATGL수평여체질지수（BMI）、FINS、담고순（TC）、삼선감유（TG）、HOMA-IR정부상관，여FFA정정상관。다원축보선성회귀분석현시：FINS、ATGL、FFA시영향CHGA수평적인소。Logistic회귀분석현시：CHGA、ATGL、FFA수평시T2DM합병NAFLD적영향인소。결론혈장CHGA화ATGL여당지、능량대사밀절상관，차량자가능통과상호작용영향T2DM합병NAFLD적발생발전。
Objective To investigate the relationship between plasma levels of chromogranin A (CHGA) and adi-pose triglyceride lipase (ATGL) in patients with type 2 diabetes (T2DM) combined non-alcoholic fatty liver disease (NAFLD). Methods The plasma levels of CHGA and ATGL were assayed by enzyme-linked immunosorbent assay (ELISA) in T2DM patients with NAFLD (group A, n=74), T2DM without NAFLD (group B, n=76), and normal group (group NC, n=75). The correlation between CHGA, ATGL and other metabolic index was analyzed. Results The plasma level of CHGA was significantly higher in group A (83.15±9.46) and group B (70.90±2.75) than that of group NC (46.74±8.15, P<0.01), and the level of CHGA was significantly higher in group A than that of group B (P<0.01). The plasma level of ATGL was sig-nificantly lower in group A (21.36±13.42) and group B (40.29±22.83) than that of group NC (72.30±26.41, P<0.01), and the level was lower in group A than that of group B (P<0.01). There was a negative correlation between the plasma CHGA, AT-GL and carbohydrate oxidation rate in group A. There was a positive correlation between fasting insulin (FINS), insulin resis-tance index (HOMA-IR), free fatty acid (FFA) and fat oxidation rate in group A. There was a negative correlation between plasma level ATGL and body mass index (BMI), FINS, cholesterol (TC), triglyceride (TG) and HOMA-IR, meanwhile, it was positively correlated with FFA. The multiple stepwise regression analysis showed that FINS, ATGL and FFA were indepen-dent variables for CHGA. The Logistic regression analysis showed that plasma levels of CHGA, ATGL and FFA were the in-dependent predictors of T2DM with NAFLD. Conclusion The plasma levels of CHGA and ATGL are closely correlated with substance and energy metabolism, and the interaction between them may play an important role in the pathogenesis of T2DM with NAFLD .