CAJ | 학술논문

目的测定2型糖尿病(T2DM)和非酒精性脂肪性肝病(NAFLD)患者血浆网膜素水平,探讨网膜素与糖脂代谢、胰岛素抵抗以及NAFLD的相关性.方法采用酶联免疫吸附试验法检测50例T2DM合并NAFLD(A组)、50例T2DM不合并NAFLD(B组)、51例糖代谢正常合并NAFLD(C组)和49例糖代谢正常不合并NAFLD(D组)血浆网膜素水平,同时检测空腹血糖、糖化血红蛋白(HbA1c)、血脂、空腹胰岛素(FINS)等临床指标,计算体质指数、腰臀比和稳态模型评估法胰岛素抵抗指数(HOMA-IR).结果 A、B、C和D组的血浆网膜素水平分别为(17.85±3.68)、(13.89±10.68)、(26.05±7.26)、(22.92±2.71)μg/L,A组和B组均低于C组和D组,A组高于B组,C组高于D组,差异均有统计学意义(P＜ 0.05).相关分析显示:血浆网膜素水平与体重、体质指数、腰围、三酰甘油、空腹血糖、FINS、HOMA-IR呈负相关(P＜ 0.05或＜0.01),与HDL-C呈正相关(P＜0.01).多元逐步回归分析显示:体质指数、HOMA-IR、FINS是影响血浆网膜素水平的独立相关因素.受试者工作特征曲线显示,糖代谢正常人血浆网膜素水平24.82 μg/L可作为预测NAFLD的风险值.结论血浆网膜素水平与糖脂代谢、胰岛素抵抗密切相关,并可能在T2DM和NAFLD的发生、发展中起重要作用.
목적 측정2형당뇨병(T2DM)화비주정성지방성간병(NAFLD)환자혈장망막소수평,탐토망막소여당지대사、이도소저항이급NAFLD적상관성.방법 채용매련면역흡부시험법검측50례T2DM합병NAFLD(A조)、50례T2DM불합병NAFLD(B조)、51례당대사정상합병NAFLD(C조)화49례당대사정상불합병NAFLD(D조)혈장망막소수평,동시검측공복혈당、당화혈홍단백(HbA1c)、혈지、공복이도소(FINS)등림상지표,계산체질지수、요둔비화은태모형평고법이도소저항지수(HOMA-IR).결과 A、B、C화D조적혈장망막소수평분별위(17.85±3.68)、(13.89±10.68)、(26.05±7.26)、(22.92±2.71)μg/L,A조화B조균저우C조화D조,A조고우B조,C조고우D조,차이균유통계학의의(P＜ 0.05).상관분석현시:혈장망막소수평여체중、체질지수、요위、삼선감유、공복혈당、FINS、HOMA-IR정부상관(P＜ 0.05혹＜0.01),여HDL-C정정상관(P＜0.01).다원축보회귀분석현시:체질지수、HOMA-IR、FINS시영향혈장망막소수평적독립상관인소.수시자공작특정곡선현시,당대사정상인혈장망막소수평24.82 μg/L가작위예측NAFLD적풍험치.결론 혈장망막소수평여당지대사、이도소저항밀절상관,병가능재T2DM화NAFLD적발생、발전중기중요작용.
Objective To assay the plasma omentin level in patients of type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD) and investigate the relationship between plasma omentin level,glucose and lipid metabolism,insulin resistance and NAFLD.Methods The plasma omentin level was assayed by enzyme-linked immunosorbent assay(ELISA) in all subjects,including patients of T2DM controls with NAFLD (group A,50 cases),T2DM without NAFLD (group B,50 cases),simple with NAFLD(group C,51 cases) and normal controls (group D,49 cases).Meanwhile,blood glucose,glycosylated hemoglobin(HbA1c),lipids and insulin levels were also measured.Body mass index (BMI) and waist-to-hip ratio were evaluated.Insulin sensitivity was assessed by HOMA-IR.Results The plasma omentin level was (17.85 ±3.68),(13.89 ±10.68),(26.05 ±7.26) and (22.92 ±2.71)μg/L in group A,B,C and D respectively.The plasma omentin level of group A and group B was significantly lower than that of group C and group D(P ＜ 0.05).The plasma omentin level of group A was higher than that of group B (P ＜ 0.05).The plasma omentin level of group C was higher than that of group D (P＜ 0.05).Correlation analysis showed that the plasma omentin level was negatively correlated to weight,BMI,waist,triglyceride,fasting blood glucose,fasting insulin (FINS) and HOMA-IR (P ＜0.05 or ＜0.01),and positively correlated to high-density lipoprotein cholesterol (HDL-C)(P ＜0.01).Multiple stepwise regression analysis showed that BMI,HOMA-IR and FINS was independent variable of omentin.The concentration of omentin was 24.82 μ g/L which could predict the risk of NAFLD in people with normal glucose regulation.Conclusions The plasma omentin level is closely correlated with glucose,lipid metabolism and insulin resistance.Plasma omentin may play an important role in the pathogenesis of T2DM and NAFLD.