肝源性糖尿病患者血清脂联素水平及与肝功能和胰岛素的相关性

Relationship between serum adiponection and liver function and insulin level in patients with hepatogenous diabetes

目的研究肝源性糖尿病患者血清脂联素水平及与肝功能和胰岛素水平的关系。方法以在聊城市人民医院住院的肝源性糖尿病患者28例（肝源性糖尿病组）、同期门诊确诊的初发单纯2型糖尿病患者27例（初发2型糖尿病组）和正常查体人员27人（对照组）为研究对象，分别检测血清脂联素、空腹血糖（FBG）、空腹胰岛素（FINS）、丙氨酸转移酶（ALT）、天冬氨酸转移酶（AST）、总胆红素（TBLL）和白蛋白（ALB）水平，并计算出胰岛素敏感指数（ISI）。结果肝源性糖尿病组和初发2型糖尿病组患者的脂联素水平均明显低于对照组（P〈0．01），肝源性糖尿病组脂联素水平明显高于初发2型糖尿病组（P〈0．05）。肝源性糖尿病组和初发2型糖尿病组ISI水平明显低于对照组（P〈0．01），肝源性糖尿病组FBG和FINS及初发2型糖尿病组FBG水平明显高于对照组（P〈0．01）；肝源性糖尿病组FINS水平明显高于初发2型糖尿病组（P〈0．05），而FBG和ISI水平明显低于初发2型糖尿病组（P〈0．05）。脂联素与FBG呈显著负相关（r=-0．6040，P=0．000），与ISI呈显著正相关（r=0．5265，P=0．000），与肝功能各指标无相关性。结论肝源性糖尿病患者存在明显胰岛素抵抗且脂联素代谢发生异常，两者可能共同影响肝源性糖尿病的发生和发展。

Objective To study the relationship between serum adiponection and liver function and insulin level in patients With hepatogenous diabetes. Methods The research subjects included： 28 patients with hepatogenous diabetes who were admitted at Liaocheng People＇s Hospital （bepatogenous diabetes group） ; 27 patients with simple type 2 diabetes without any complication （simple type 2 diabetes group）, and 27 normal controls （control group）. Blood adiponectin, fasting blood glucose （FBG）, fasting insulins （FINS）, alanine aminotransferase （ALT） , aspartate transferase （AST） , total bilirubin （TBIL） and albumin （ALB） were measured, and accordingly the insulin sensitivity index （ISI） was calculated. Resalts Compared with the control group , serum adiponectin levels and ISI levels were significantly lower in the other two groups （ P 〈 0. 01 ）, and the adiponectin levels were significantly higher in hepatogenous diabetes group than in simple type 2 diabetes group （ P 〈 0. 05 ）. The FBG and FINS levels in the hepatogenous diabetes group and the FBG levels in the simple type 2 diabetes group were significantly higher than those in control group （P 〈 0.01 ）. The FINS levels were significantly higher in the hepatogenous diabetes group than in simple diabetes group （ P 〈 0.05 ）, while the levels of FBG and ISI were lower than that of simple type 2 diabetes group （ P 〈 0.05 ）. Adiponectin levels were negatively correlated with ISI （ r = 0. 5265, P = 0. 000） , and positively correlated with FBG （ r = - 0. 6040, P = 0. 000） , and were not correlated with liver functions. Conclusion Insulin resistance and abnormal metabolism of adiponection exist in patients with hepatogenous diabetes and may together affect the occurrence and development of hepatogenous diabetes.