中老年Ⅱ型糖尿病患者伴发脂肪肝与血清瘦素及血脂水平的关系

Relationship between fatty liver and the level of serum leptin and lipids in type Ⅱ diabetic patients in the middle and elderly age

目的:探讨Ⅱ型糖尿病(T2DM)伴发脂肪肝与血清瘦素及血脂水平的关系。方法:随机选取T2DM患者96例,其中合并脂肪肝者41例,无脂肪肝者55例,进行肝脏B超检查,并用放免法测定其血清瘦素,同时测定空腹血糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TG)、甘油三酯(TG)等,计算模型胰岛素抵抗指数HOMA-IR。结果:T2DM合并脂肪肝组的体重指数(BMI)、瘦素、TC水平显著高于无脂肪肝组(P<0.05);HOMA-IR高于无脂肪肝组(P=0.06)。对T2DM患者的单因素相关分析显示,瘦素与性别、BMI、HOMA-IR、TC正相关。T2DM患者发生脂肪肝与各临床指标的Logistic逐步回归分析结果示在P<0.05水平进入的变量为BMI和TG。结论:T2DM合并脂肪肝与肥胖、胰岛素抵抗、高瘦素血症、高TG血症密切相关。BMI和TG是T2DM患者脂肪肝形成的主要危险因素。

[Objective]To study the relationship between fatty liver and the Level of Serum Leptin and Lipids in type 2 diabetic patients in the middle and elderly age.[Method]96 type 2 diabetic patients were selected randomly,of which 41 patients with fatty liver,55 patients without fatty liver,and liver ultrasonography was perfonned.The leptin concentration was measured by radioimmunoassay.In conjunction with plasma glucose,serum insulin and lipids were measured.HOMA model was used to calculate HOMA-IR.[Result]The BMI,leptin,HOMA-IR,and TG of Type 2 diabetic patients with fatty liver are higher than those without fatty liver.Gender,BM,HOMA-IR and TG are associative with the Level of serum Leptin.The result of logistic regression indicates that BMI and TG are important associative factors in the patients of type 2 diabetes with fatty liver. [Conclusion]Obesity,insulin resistance,hyperleptinemia and hypertrig-lyceridemia are correlated to fatty liver in type 2 diabetic patients.BMI and TG are the most important predictive factor for fatty liver in type 2 diabetic patients