中老年2型糖尿病合并非酒精性脂肪肝患者脂肪细胞因子与下肢动脉粥样硬化的相关性

发布时间：2018-08-07 17:18

【摘要】：目的探讨血清脂肪细胞因子与2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者下肢动脉粥样硬化的相关性。方法记录176例T2DM合并NAFLD患者入院后的一般临床资料,检测入院时血清脂联素、瘦素、白细胞介素(IL)-6且均接受彩色多普勒超声检测下肢动脉,按照动脉内-中膜厚度(IMT)及踝臂指数(ABI)分为Ⅰ组(IMT1 mm,n=42)、Ⅱ组(1 mm≤IMT≤1.2 mm,n=55)、Ⅲ组(IMT1.2 mm,n=79);ABI1.3组(n=64)、0.9~1.3组(n=76)及0.9组(n=36);同期另选50例体检健康者为对照组。结果Ⅰ组、Ⅱ组、Ⅲ组、对照组体质指数(BMI)、舒张压(DBP)、空腹血糖(FPG)、2 h餐后血糖(2 h PG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)存在统计学差异(P0.05),Ⅲ组BMI、DBP高于对照组;Ⅲ组FPG、2 h PG、Hb A1c、LDL-C高于Ⅱ组、Ⅰ组及对照组(P0.05);Ⅲ组TG、TC亦高于Ⅰ组及对照组(P0.05);四组血清脂联素、瘦素、IL-6亦存在显著差异(P0.05),血清瘦素、IL-6水平从对照组到Ⅲ组逐渐增高(P0.05),而血清脂联素则逐渐降低(P0.05);ABI1.3组、ABI 0.9~1.3组及ABI0.9组血清瘦素、IL-6水平逐渐增高(P0.05),血清脂联素则逐渐降低(P0.05);IMT及ABI分别与瘦素、IL-6呈现正相关,而与脂联素呈负相关;多元逐步回归分析提示:血清瘦素、IL-6与IMT呈独立正相关(P0.05),而脂联素则与其呈独立负相关(P0.05);多因素非条件Logistic回归分析提示:血清瘦素、IL-6是发生ABI0.9的高危因素,而脂联素则是其保护因素。结论血清高水平瘦素、IL-6与T2DM合并NAFLD患者下肢动脉粥样硬化的形成及发展密切相关,脂联素则可能抗炎抑制粥样硬化形成,从而延缓下肢动脉粥样硬化性疾病的发生。
[Abstract]:Objective to investigate the relationship between serum adipocyte factors and lower extremity atherosclerosis in patients with type 2 diabetes mellitus (T2DM) and non alcoholic fatty liver (NAFLD). Methods the general clinical data of 176 patients with T2DM complicated with NAFLD were recorded. Serum adiponectin, leptin and interleukin (IL) -6 were detected on admission. The arteries of lower extremity were detected by color Doppler ultrasound. According to intima-media thickness (IMT) and malleolus brachial index (ABI), (IMT) was divided into three groups: group 鈪，

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