2型糖尿病合并非酒精性脂肪性肝病患者血清总脂联素和高分子量脂联素水平的变化
Change of serum total and high molecular weight adiponectin levels in type 2 diabetic patients with nonalcoholic fatty liver disease
目的 探讨2型糖尿病合并非酒精性脂肪性肝病(NAFLD)患者血清总脂联素和高分子量脂联素(high molecular weight adiponectin,HMW APN)水平的变化及其临床意义.方法 选取正常对照组55名、单纯2型糖尿病组58例、2型糖尿病合并NAFLD组59例,收集临床及生化资料,酶联免疫法测定血清总脂联素和HMW APN水平.结果 (1)合并NAFLD的2型糖尿病患者谷丙转氨酶、总胆固醇水平均高于对照组(P<0.01),同时其体重指数(BMI)、谷草转氨酶、甘油三酯(TG)和空腹胰岛素均高于对照组和单纯2型糖尿病患者(P<0.05或P<0.01),高密度脂蛋白胆固醇(HDL-C)低于对照组和单纯2型糖尿病患者(P<0.01).(2)2型糖尿病组总脂联素、HMW APN、高分子量和总脂联素比值低于对照组,2型糖尿病合并NAFLD组总脂联素、HMW APN水平低于2型糖尿病组(P<0.01).(3)回归分析显示,稳态模型评估的胰岛素抵抗指数(HOMA-IR)、TG和HDL-C是血清脂联素水平的预测因素;TG、BMI是2型糖尿病合并NAFLD的危险因素,而总脂联素及HMW APN是其保护因素(OR分别为0.701和0.489).结论 低脂联素血症在2型糖尿病合并NAFLD的发生、发展中可能起重要作用.
更多Objective To investigate the changes and clinical significance of serum total and high molecular weight adiponectin (HMW APN) levels in type 2 diabetic patients with non-alcoholic fatty liver disease (NAFLD).Methods Serum levels of total adiponectin and HMW APN were measured by ELISA,in 58 type 2 diabetic patients with nonalcoholic fatty liver disease (T2DM with NAFLD group),59 type 2 diabetic patients without nonalcoholic fatty liver disease (T2DM group),and 55 control subjects with normal glucose tolerance and without nonalcoholic fatty liver disease (NC group).Results (1) Alanine transaminase and total cholesterol levels were significantly higher in T2DM with NAFLD group than those in NC group(P<0.01),while body mass index (BMI),aspartate aminotransferase,triglyceride (TG),and fasting insulin were also significantly increased (P<0.05 or P< 0.01),and high density lipoprotein-cholesterol (HDL-C) were significantly decreased compared with those in NC and T2DM groups (P<0.01).(2) Total adiponectin,HMW APN,and the ratio of HMW APN to total adiponectin in T2DM group were lower than those in NC group.Total adiponectin and HMW APN levels in T2DM with NAFLD group were significantly lower than those in T2DM group(P<0.01).(3) Regression analysis showed that homeostasis model assessment insulin resistance index (HOMA-IR),TG,and HDL-C levels were independent predicting factors for total adiponectin and HMW APN levels.TG and BMI were independent risk factors for T2DM complicated with NAFLD,while total adiponectin and HMW APN levels were the protective ones (OR =0.701,0.489,respectively).Conclusions Hypoadiponectinemia may partially play an important role in the development and progression of NAFLD in T2DM.
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