Ⅱ型糖尿病合并脂肪肝患者血清淀粉样蛋白A水平的临床研究

Clinical study on serum amyloid A of type 2 diabetics with fatty liver disease

目的探讨血清淀粉样蛋白A(SSA)在新诊断的Ⅱ型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者中的临床意义。方法将79例新诊断T2DM的分为NAFLD组患者39例,非NAFLD组患者40例,分别测定体质量指数(BMI)、腰臀比(W/H)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、空腹血糖(FPG)、空腹胰岛素(FINS)、血清淀粉样蛋白A(SSA)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI)。结果 NAFLD组患者的血清SSA以及BMI、W/H、ALT、AST、FINS、TG及HOMA-IR较非NAFLD组患者显著增高(P<0.01),NAFLD组的年龄I、SI、HDL显著降低(P<0.01)。新诊断的T2DM是否合并NAFLD与年龄、BMI、FINS及SSA有相关性(P<0.05)。SSA与BMI,FINS,W/H呈正相关(P<0.05)。结论 BMI、空腹胰岛素及SSA水平是新诊断的T2DM合并NAFLD的危险因素,并且BMI、腰臀比、空腹胰岛素水平与SSA水平具有相关性。

Objective To investigate the clinical significance of serum amyloid A of newly diagnosed type 2 diabetics（T2DM） with nonalcoholic fatty liver disease（NAFLD）.Methods 79 patients with T2DM were divided into two groups,39 diabetics with NAFLD and 40 diabetics without NAFLD.Body mass index（BMI）,fasting blood glucose（FPG）,insulin（FINS）,serum amyloid A,glycosylated hemoglobin（HbA1c）,cholesterol total（TC）,triglyceride（TG）,high density lipoprotein（HDL-C） and low density lipoprotein（LDL-C） were measured.Insulin resistance index（HOMA-IR） and insulin sensitivity index（ISI） were calculated.Results The levels of serum amyloid A and BMI,W/H,ACT,AST,FINS,TG and HOMA-IR in the diabetics with NAFLD were significantly higher than that in type 2 diabetics without NAFLD（P0.01）.The levels of age and ISI were significantly lower than those T2DM without NAFLD（P0.01）.The level of SSA was positive correlated with BMI（r=0.277,P0.05）,FINS（r=0.283,P0.05）,W/H（r=0.276,P0.05） respectively.Conclusion The levels of BMI,FINS and SSA are risk factors in newly diagnosed type 2 diabetics with NAFLD.The levels of BMI,W/H and FINS are correlated with SSA.