中国糖尿病杂志
中國糖尿病雜誌
중국당뇨병잡지
CHINESE JOURNAL OF DIABETES
2015年
2期
131-134
,共4页
边树伟%周志安%张杰%贺宇
邊樹偉%週誌安%張傑%賀宇
변수위%주지안%장걸%하우
非酒精性脂肪性肝病%糖尿病,2型%脂联素%内脂素%胰岛素抵抗
非酒精性脂肪性肝病%糖尿病,2型%脂聯素%內脂素%胰島素牴抗
비주정성지방성간병%당뇨병,2형%지련소%내지소%이도소저항
Non-alcoholic fatty liver disease (NAFLD )%Diabetes mellitus,type 2%Adiponectin (APN)%Visfatin%Insulin resistance
目的：探讨T2DM合并非酒精性脂肪性肝病（NAFLD）患者血清脂联素（APN）和内脂素的变化及临床意义。方法选取2011年9月至2013年3月于我院就诊的T2DM患者240例，根据中华医学会NAFLD诊断标准将研究对象分为单纯T2DM 组148例和 T2DM 合并NAFLD组92例，另选正常体检者106名（NC组）。根据影像学诊断再将 T2DM 合并NAFLD组分为轻度亚组33例，中度亚组30例和重度亚组29例，比较各亚组血清APN和内脂素水平。结果 T2DM组和T2DM合并NAFLD组内脂素、BMI、WC、WHR、AST、ALT、FPG、FIns、TG、TC及胰岛素抵抗指数（HOMA‐IR）较NC组升高（P＜0.05或 P＜0.01）。T2DM 合并NAFLD组血清 APN水平较 NC组和 T2DM 组降低（P＜0.01）， T2DM 组较NC组降低（P＜0.01）。T2DM 合并NAFLD组轻、中、重度亚组 HOMA‐IR逐渐升高；血清APN水平逐渐降低，且轻、中、重度亚组间比较差异均有统计学意义（P＜0.05）；血清内脂素水平逐渐升高，但轻度和中度亚组间比较差异无统计学意义（P＞0.05）。结论 T2DM 合并 NAFLD患者血清APN较正常人明显降低，且与NAFLD严重程度相关。低脂联素血症可能与NAFLD发生发展有关；内脂素水平随N A FLD严重程度升高，提示可能参与了向脂肪性肝炎及肝脏纤维化的发展。
目的：探討T2DM閤併非酒精性脂肪性肝病（NAFLD）患者血清脂聯素（APN）和內脂素的變化及臨床意義。方法選取2011年9月至2013年3月于我院就診的T2DM患者240例，根據中華醫學會NAFLD診斷標準將研究對象分為單純T2DM 組148例和 T2DM 閤併NAFLD組92例，另選正常體檢者106名（NC組）。根據影像學診斷再將 T2DM 閤併NAFLD組分為輕度亞組33例，中度亞組30例和重度亞組29例，比較各亞組血清APN和內脂素水平。結果 T2DM組和T2DM閤併NAFLD組內脂素、BMI、WC、WHR、AST、ALT、FPG、FIns、TG、TC及胰島素牴抗指數（HOMA‐IR）較NC組升高（P＜0.05或 P＜0.01）。T2DM 閤併NAFLD組血清 APN水平較 NC組和 T2DM 組降低（P＜0.01）， T2DM 組較NC組降低（P＜0.01）。T2DM 閤併NAFLD組輕、中、重度亞組 HOMA‐IR逐漸升高；血清APN水平逐漸降低，且輕、中、重度亞組間比較差異均有統計學意義（P＜0.05）；血清內脂素水平逐漸升高，但輕度和中度亞組間比較差異無統計學意義（P＞0.05）。結論 T2DM 閤併 NAFLD患者血清APN較正常人明顯降低，且與NAFLD嚴重程度相關。低脂聯素血癥可能與NAFLD髮生髮展有關；內脂素水平隨N A FLD嚴重程度升高，提示可能參與瞭嚮脂肪性肝炎及肝髒纖維化的髮展。
목적：탐토T2DM합병비주정성지방성간병（NAFLD）환자혈청지련소（APN）화내지소적변화급림상의의。방법선취2011년9월지2013년3월우아원취진적T2DM환자240례，근거중화의학회NAFLD진단표준장연구대상분위단순T2DM 조148례화 T2DM 합병NAFLD조92례，령선정상체검자106명（NC조）。근거영상학진단재장 T2DM 합병NAFLD조분위경도아조33례，중도아조30례화중도아조29례，비교각아조혈청APN화내지소수평。결과 T2DM조화T2DM합병NAFLD조내지소、BMI、WC、WHR、AST、ALT、FPG、FIns、TG、TC급이도소저항지수（HOMA‐IR）교NC조승고（P＜0.05혹 P＜0.01）。T2DM 합병NAFLD조혈청 APN수평교 NC조화 T2DM 조강저（P＜0.01）， T2DM 조교NC조강저（P＜0.01）。T2DM 합병NAFLD조경、중、중도아조 HOMA‐IR축점승고；혈청APN수평축점강저，차경、중、중도아조간비교차이균유통계학의의（P＜0.05）；혈청내지소수평축점승고，단경도화중도아조간비교차이무통계학의의（P＞0.05）。결론 T2DM 합병 NAFLD환자혈청APN교정상인명현강저，차여NAFLD엄중정도상관。저지련소혈증가능여NAFLD발생발전유관；내지소수평수N A FLD엄중정도승고，제시가능삼여료향지방성간염급간장섬유화적발전。
Objective To investigate the serum levels of adiponectin (APN) and visfatin in patients with type 2 diabetes and nonalcoholic fatty liver disease(NAFLD)and its clinical significance. Methods 230 cases of T2DM patients admitted to our hospital from September 2011 to March 2013 were divided into T2DM group (148 cases) and T2DM plus NAFLD group (92 cases) according to the Chinese Medical Association diagnostic criteria for NAFLD subjects. 106 healthy people was selected as control. Patients with T2DM plus NAFLD were further divided into mild (38 cases) ,moderate (28 cases) and severe (26 cases) groups based on NAFLD severity.Serum APN and visfatin levels were compared among groups. Results Compared with NC group ,T2DM and T2DM plus NAFLD groups showed the increased levels of visfatin ,BMI ,WC ,WHR ,ALT ,ALT ,FPG ,FIns ,TG ,TC and HOMA‐IR (P< 0.05 or P<0.01). Serum APN levels were lower in T2DM plus NAFLD than in NC group and T2DM group (P<0.01) and serum APN levels were lower in T2DM group than in NC group (P<0.01). HOMA‐IR was positively correlated to disease severity in patients with T 2DM plus NAFLD ;serum APN levels were negatively correlated to disease severity(both P<0.05);visfatin level was positively correlated to disease severity in patients with T2DM plus NAFLD ,but the difference between mild and moderate groups was not statistically significant (P> 0.05). Conclusion APN is significantly lower in patients with T2DM plus NAFLD than in normal individuals ,and is correlated with NAFLD severity. Hypoadiponectinemia may be related to the development of NAFLD ;visfatin significantly is increasedin severe NAFLD and NAFLD may be involved in the development of liver fibrosis.
