血清游离脂肪酸、骨钙素与初诊2型糖尿病患者胰腺脂肪浸润程度的相关性研究

Study on the relationship of serum FFA, BGP with the course of pancreatic fat infiltration in patients with newly diagnosed T2DM

目的研究血清游离脂肪酸(FFA)、骨钙素(BGP)与初诊2型糖尿病(T2DM)患者胰腺脂肪浸润(PFI)程度的关系。方法将2019年1月至2020年12月西安市第三医院就诊的110例初诊T2DM患者纳入本次回顾性研究,T2DM患者根据有无PFI分为单纯T2DM组(n=25)和T2DM+PFI组(n=85),T2DM+PFI组患者根据PFI程度分为轻度组(n=28)、中度组(n=35)、重度组(n=22)。另选同时间段的50名健康受试者纳入对照组。收集并比较各组的血糖指标[空腹血糖(FPG)、糖化血红蛋白(Hb A1c)]、血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]和胰岛素抵抗指数(HOMA-IR)以及血清FFA、BGP;用MRI技术定量检查T2DM患者的胰腺脂肪分数(PFF);比较T2DM+PFI患者不同严重程度血清FFA、BGP、PFF水平;用Pearson法分析血清FFA、BGP与PEF的相关性。结果T2DM+PFI组及单纯T2DM组的TC、TG、LDL-C、FPG、Hb A1c、HOMA-IR均显著高于对照组,且T2DM+PFI组高于单纯T2DM组,而HDL-C则完全相反,差异均有统计学意义(P<0.05)。T2DM+PFI组的血清FFA较单纯T2DM组及对照组高,而血清BGP低于单纯T2DM组及对照组,差异均有统计学意义(P<0.05)。轻度组、中度组和重度组患者血清FFA依次升高,而BGP依次降低,差异均有统计学意义(P<0.05)。初诊T2DM+PFI患者血清FFA与BGP呈负相关(r=-0.866,P<0.05),与PFF呈正相关(r=0.651,P<0.05);血清BGP与PFF呈负相关(r=-0.712,P<0.05)。结论初诊T2DM+PFI患者血清FFA显著升高,而BGP完全相反,两种指标均与PFI严重程度有关,可能在诊断T2DM患者合并PFI有一定临床价值。

Objective To study the relationship of serum free fatty acid(FFA),osteocalcin(BGP)with the degree of pancreatic fat infiltration(PFI)in patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods A total of 110 patients with newly diagnosed T2DM in Xi'an No.3 Hospital from January 2019 to December 2020 were enrolled in this retrospective study.Based on with or without PFI,T2DM patients were divided into simple T2DM group(n=25)and T2DM+PFI group(n=85).T2DM+PFI group was divided into mild group(n=28),moderate group(n=35)and severe group(n=22)based on the degree of PFI.Another 50 healthy subjects at the same time were selected into the control group.The indexes related to blood glucose[fasting plasma glucose(FPG),hemoglobin A1c(HbA1c)],blood lipids[total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]and insulin resistance(HOMA-IR)were collected and compared,serum FFA and BGP were also determined,and the pancreatic fat fraction(PFF)of T2DM patients was quantitatively detected by MRI technique.Serum FFA,BGP and PFF levels of different severity in T2DM+PFI patients were compared.The correlation of serum FFA,BGP with PEF was analyzed by Pearson method.Results TC,TG,LDL-C,FPG,HbA1c,HOMA-IR in T2DM+PFI group and simple T2DM group were significantly higher than those in control group,and those in T2DM+PFI group were higher than those in simple T2DM group,while HDL-C was just opposite,the differences were statistically significant(P<0.05).Serum FFA in T2DM+PFI group was higher than that in simple T2DM group and control group,while serum BGP was lower than that in simple T2DM group and control group,the differences were statistically significant(P<0.05).Serum FFA in mild group,moderate group and severe group increased,while BGP decreased in turn,the differences were statistically significant(P<0.05).In newly diagnosed T2DM patients with PFI,serum FFA level was negatively correlated with BGP level(r=-0.866,P<0.05),positively correlated with PFF(r=0.651,P<0.05),and serum BGP level was negatively correlated with PFF(r=-0.712,P<0.05).Conclusion Serum FFA is significantly increased in newly diagnosed T2DM patients with PFI,while BGP is on the contrary.Both indexes are related to the severity of PFI,which may have certain clinical value in the diagnosis of T2DM patients with PFI.