2型糖尿病非酒精性脂肪性肝病患者血清脂联素及内脂素的变化及其临床意义的研究

发布时间：2018-02-26 00:36

本文关键词： 非酒精性脂肪性肝病糖尿病型脂联素内脂素胰岛素抵抗　出处：《中国糖尿病杂志》2015年02期 　论文类型：期刊论文

【摘要】：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(P0.05或P0.01)。T2DM合并NAFLD组血清APN水平较NC组和T2DM组降低(P0.01),T2DM组较NC组降低(P0.01)。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(P0.05);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(P0.05)。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NAFLD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。
[Abstract]:Objective to investigate the changes and clinical significance of serum adiponectin (APN) and endogenous adiponectin (et) in patients with T2DM complicated with NAF LDD. Methods 240 patients with T2DM from September 2011 to March 2013 were selected. According to the NAFLD diagnostic criteria of the Chinese Medical Association, the subjects were divided into two groups: simple T2DM group (148 cases), T2DM combined with NAFLD group (92 cases) and normal physical examination group (106 cases). According to the imaging diagnosis, T2DM combined with NAFLD group was further divided into mild subgroup (33 cases). 30 cases in moderate subgroup and 29 cases in severe subgroup, Results Serum APN levels in T2DM group and T2DM combined with NAFLD group were significantly lower than those in NC group (P 0.05 or P0.01.T2DM combined with NAFLD group). Results Serum APN levels in T2DM group and T2DM combined with NAFLD group were lower than those in NC group (P 0.05 or P0.01.T2DM + NAFLD group), and the levels of serum APN in T2DM group were lower than those in NC group and T2DM group. The patients with low P0.01U. T2DM combined with NAFLD were mild. In moderate and severe subgroups, HOMA-IR increased gradually, serum APN level decreased gradually, and the differences between mild, moderate and severe subgroups were statistically significant (P 0.05), and serum lipid level gradually increased. However, there was no significant difference between mild and moderate subgroups (P 0.05). Conclusion Serum APN in T2DM patients with NAFLD is significantly lower than that in normal controls, and is related to the severity of NAFLD. Hypoadiponectinemia may be related to the occurrence and development of NAFLD. The level of endolipin increased with the severity of NAFLD, suggesting that it might be involved in the development of steatohepatitis and hepatic fibrosis.
【作者单位】：承德市中心医院老年病科;
【分类号】：R587.1;R575.5

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