2型糖尿病合并非酒精性脂肪肝患者血清铁蛋白水平与氧化应激、胰岛素抵抗的关系

Relationship between serum ferritin,oxidative stress and insulin resistance in type 2 diabetic patients with nonalcoholic fatty liver disease

目的探讨合并非酒精性脂肪肝(NAFLD)的2型糖尿病(T2DM)患者血清铁蛋白(SF)水平与氧化应激、胰岛素抵抗的关系。方法对44例T2DM患者(A组,22例,无NAFLD;B组,22例,合并NAFLD)和健康体检者(C组,22例)检测了血总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、SF和丙二醛(MDA)水平,并采用稳态模型评估胰岛素抵抗指数(HOMA-IR)。结果 A组和B组的SF、MDA水平高于C组(P<0.01),B组SF、MDA水平显著高于A组(P<0.01)。SF水平与病程、体重指数、TC、TG、HbA1c、FPG、FINS、HOMA-IR、MDA水平呈正相关。结论 T2DM合并NAFLD患者体内铁超负荷;氧化应激、胰岛素抵抗可能参与了NAFLD的发生发展。

Objective To investigate the relationship between serum ferritin（SF）, oxidative stress and insulin resistance （IR） in the patients with type 2 diabetes （T2DM） combined with nonalcoholic fatty liver disease（NAFLD）. Methods A study was carried out in 22 T2DM patients without NAFLD（group A）, 22 T2DM patients with NAFLD（group B）, and 22 healthy subjects（group C）. The measurements included height, weight, blood pressure, total cholesterol （TC）, triglyceride （TG）, fasting plasma glucose（FPG）, fasting insulin（FINS）, glycosylated hemoglobin lc（HbAlc）, SF, and malonaldehyde（MDA）. Homeostasis model assessment of insulin resistance（HOMA-IR） was used to estimate IR. Results The SF and MDA levels were significantly higher in groups of A and B than those in group C （P〈0. 01）, which were significantly higher in group B than those in group A （P〈0. 01）. SF level was positively correlated with duration, BMI, TC, TG, HbAlc, FPG, FINS, HOMA-IR and MDA（P〈0. 05）. Conclusion Iron overload exists in T2DM patients with NAFLD. The increase of oxidative stress and insulin resistance may be involved in the occurrence and development of NAFLD in T2DM patients.