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目的探讨T2DM合并非酒精性脂肪性肝病(NAFLD)患者血清游离脂肪酸(FFA)和脂联素(APN)的表达及意义。方法选取T2DM患者40例、T2DM合并NAFLD患者40例、健康对照组20例,测定三组静脉血空腹血糖(FPG)、胆固醇(TC)、甘油三酯(TG)、丙氨酸转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(GGT)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)以及血清FFA和APN水平。结果与对照组比较,T2DM组的BMI、FPG、FINS、HbA1c水平和胰岛素抵抗指数(HOMA-IR)增高(P均<0.05)。T2DM合并NAFLD组BMI、FPG、FINS、TC、TG、ALT、AST、GGT、FFA水平和HOMA-IR均显著高于T2DM组,APN水平低于T2DM组(P均<0.01)。APN水平与BMI、FPG、HOMA-IR、TC、TG、ALT、AST、GGT、FFA水平呈负相关(P均<0.01)。结论 FFA的升高与APN的降低可能是T2DM合并NAFLD关键的发病机制之一。
Objective To investigate the expression and significance of serum free fatty acid (FFA) and adiponectin (APN) in T2DM patients with non-alcoholic fatty liver disease (NAFLD). Methods Forty patients with T2DM, 40 patients with T2DM and NAFLD and 20 healthy controls were enrolled in this study. Fasting blood glucose (FPG), cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT) , AST, GGT, HbA1c, FINS and serum FFA and APN levels were measured. Results Compared with the control group, the levels of BMI, FPG, FINS, HbA1c and HOMA-IR in T2DM group were significantly increased (all P <0.05). The levels of BMI, FPG, FINS, TC, TG, ALT, AST, GGT, FFA and HOMA-IR in T2DM with NAFLD were significantly higher than those in T2DM and APN were lower than those in T2DM (all P <0.01). The level of APN was negatively correlated with the levels of BMI, FPG, HOMA-IR, TC, TG, ALT, AST, GGT and FFA (all P <0.01). Conclusions The increase of FFA and the decrease of APN may be one of the key pathogenesis of T2DM with NAFLD.