CAJ | 학술논문

目的：研究2型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）患者血浆网膜素-1与脂联素和肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、高敏C反应蛋白（hs-CRP）等炎症因子的关系。方法采用酶联免疫吸附法（ELISA）检测T2DM合并NAFLD组（A组，63例）、T2DM不合并NAFLD组（B组，63例）和正常对照组（C组，70例）的血浆网膜素-1和脂联素水平，同时测定上述3组生化指标及炎症指标（hs-CRP、TNF-α和IL-6），应用相关分析和多元回归分析方法分析血浆网膜素-1与脂联素及炎症指标的关系，应用Logistic回归分析T2DM合并NAFLD的影响因素。结果 A组血浆网膜素-1（27.02±2.82）μg/L、脂联素水平（11.98±3.63）mg/L低于B组[分别为（31.52±2.81）μg/L、（15.85±3.28）mg/L]和C组[分别为（35.92±2.80）μg/L、（19.88±3.44）mg/L]，且B组低于C组（P＜0.01），A组血浆网膜素-1水平与脂联素、高密度脂蛋白胆固醇（HDL-C）正相关，与TNF-α、IL-6、空腹血糖（FBG）、胰岛素抵抗指数（HOMA-IR）、内脏脂肪面积、腰围、腰臀比（WHR）、游离脂肪酸（FFA）负相关（P＜0.05或P＜0.01）；多元逐步线性回归分析表明脂联素、TNF-α、IL-6是血浆网膜素-1水平的影响因素。Logistic回归分析显示网膜素-1、hs-CRP、内脏脂肪面积及游离脂肪酸（FFA）是T2DM合并NAFLD的独立影响因素（P＜0.01）。结论 T2DM患者合并NAFLD与网膜素-1降低相关，网膜素-1表达可能会受到脂联素及炎症因子的影响。
목적：연구2형당뇨병（T2DM）합병비주정성지방성간병（NAFLD）환자혈장망막소-1여지련소화종류배사인자（TNF）-α、백세포개소（IL）-6、고민C반응단백（hs-CRP）등염증인자적관계。방법채용매련면역흡부법（ELISA）검측T2DM합병NAFLD조（A조，63례）、T2DM불합병NAFLD조（B조，63례）화정상대조조（C조，70례）적혈장망막소-1화지련소수평，동시측정상술3조생화지표급염증지표（hs-CRP、TNF-α화IL-6），응용상관분석화다원회귀분석방법분석혈장망막소-1여지련소급염증지표적관계，응용Logistic회귀분석T2DM합병NAFLD적영향인소。결과 A조혈장망막소-1（27.02±2.82）μg/L、지련소수평（11.98±3.63）mg/L저우B조[분별위（31.52±2.81）μg/L、（15.85±3.28）mg/L]화C조[분별위（35.92±2.80）μg/L、（19.88±3.44）mg/L]，차B조저우C조（P＜0.01），A조혈장망막소-1수평여지련소、고밀도지단백담고순（HDL-C）정상관，여TNF-α、IL-6、공복혈당（FBG）、이도소저항지수（HOMA-IR）、내장지방면적、요위、요둔비（WHR）、유리지방산（FFA）부상관（P＜0.05혹P＜0.01）；다원축보선성회귀분석표명지련소、TNF-α、IL-6시혈장망막소-1수평적영향인소。Logistic회귀분석현시망막소-1、hs-CRP、내장지방면적급유리지방산（FFA）시T2DM합병NAFLD적독립영향인소（P＜0.01）。결론 T2DM환자합병NAFLD여망막소-1강저상관，망막소-1표체가능회수도지련소급염증인자적영향。
Objective To investigate the relationship of omentin-1 with adiponectin and inflammatory cytokines in type 2 diabetes (T2DM) patients with nonalcoholic fatty liver disease (NAFLD). Methods The serum levels of omentin-1 and adiponectin were assayed by enzyme-linked immunosorbent assay (ELISA) in patients of T2DM with NAFLD (group A, n=63), T2DM without NAFLD (group B, n=63)and normal control group (group C, n=70). At the same time the biochemical markers and inflammatory marker, such as tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hs-CRP) and interleukin 6(IL-6) were detected in three groups. The correlation analysis and multiple regression analysis were used to de-tect the association of omentin-1 with adiponectin and inflammatory markers. The logistic regression was used to analyze fac-tors influencing NAFLD in patients with T2DM. Results The serum levels of omentin-1 and adiponectin were significant-ly lower in group A [ (27.02±2.82)μg/L and (11.98±3.63) mg/L] than those of group B [(31.52±2.81)μg/L and (15.85±3.28) mg/L] and group C [(35.92±2.80)μg/L and (19.88±3.44) mg/L], and there were significantly lower levels of them in group B than those of group C (P<0.01). The plasma omentin-1 level was positively correlated with adiponectin and high density li-poprotein (HDL-C) in group A. Also the plasma omentin-1 level was negatively correlated with TNF-α, IL-6, fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), visceral adipose tissue, waist, waist-to-hip ratio (WHR) and free fatty acid in group A (P<0.05 or P<0.01). Multiple stepwise regression analysis showed that adipo-nectin, TNF-αand IL-6 were independent factors influencing the level of plasma omentin-1. Logistic regression analysis showed that omentin-1 was one of independent factors influencing T2DM combined with NAFLD (P<0.01). Conclusion The incident of NAFLD in T2DM patients is related to the lower level of omentin-1, which may be influenced by adiponectin and inflammatory factors.