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目的研究2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)与血清脂联素(APN)的相关性。方法选取2011年8月—2013年7月宁波大学医学院附属医院收治的76例初发或病史<3年的T2DM患者,按照是否合并NAFLD分为T2DM+NAFLD和T2DM两组,每组各38例,另选30名正常体检者作为对照组(NC组)。测量三组的体质指数(BMI)、血脂、血糖、肝功能、胰岛素抵抗指数(HOMA-IR)和APN等指标水平并进行比较。结果 T2DM+NAFLD组的BMI、三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、空腹胰岛素(FINS)及HOMA-IR等指标水平明显高于T2DM组和NC组,APN水平明显低于其他两组(P<0.05);Pearson相关分析显示,APN与BMI、高密度脂蛋白胆固醇(HDL-C)和HOMA-IR呈负相关,与TC、LDL-C和ALT呈正相关(P均<0.05);多元线性回归分析显示HDL-C、HOMA-IR是APN的独立影响因子(P<0.05)。结论 T2DM合并NAFLD患者存在严重的胰岛素抵抗和糖脂代谢紊乱,APN水平是影响NAFLD发生与发展的关键因子。
Objective To investigate the relationship between type 2 diabetes mellitus (T2DM) with non-alcoholic fatty liver disease (NAFLD) and serum adiponectin (APN). Methods Totally 76 T2DM patients with newly diagnosed or history less than 3 years admitted from Affiliated Hospital of Ningbo University Medical College between August 2011 and July 2013 were divided into two groups according to their NAFLD and T2DM with NAFLD and T2DM Cases, another 30 normal subjects were selected as a control group (NC group). Body mass index (BMI), blood lipid, blood glucose, liver function, insulin resistance index (HOMA-IR) and APN were measured and compared in three groups. Results The levels of BMI, triglyceride (TG), cholesterol (TC), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), fasting insulin (FINS) and HOMA-IR in T2DM + NAFLD group (P <0.05). Pearson correlation analysis showed that there was a negative correlation between APN and BMI, HDL-C and HOMA-IR in T2DM and NC groups, (P <0.05). The multiple linear regression analysis showed that HDL-C and HOMA-IR were independent influencing factors of APN (P <0.05). Conclusion The patients with T2DM complicated with NAFLD have severe insulin resistance and disorders of glucose and lipid metabolism. APN level is the key factor affecting the occurrence and development of NAFLD.