2型糖尿病合并非酒精性脂肪性肝病患者的血内皮素-1水平与胰岛素抵抗的相关性研究

Correlation Between Plasma Endothlin-1 and Insulin Resistance in Patients with Type 2 Diabetes with Nonalcoholic Fatty Liver Disease

目的探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者的内皮素-1(ET-1)与胰岛素抵抗(IR)的相关性。方法将99例T2DM患者分为单纯糖尿病组(A组)51例,合并NAFLD组(B组)48例,分别测定身高、体重、收缩压(SBP)、舒张压(DBP),抽空腹血检查内皮素-1(ET-1)、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白A1c(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)。并计算体重指数(BMI)、胰岛素抵抗指数(HOMA-IR)、胰岛素作用指数(IAI)及定量胰岛素敏感性指数(QUICKI)。结果 B组的体重、BMI、FINS、HOMA-IR、ET-1、SBP、DBP、ALT、AST、GGT均明显高于A组(P<0.05),IAI、QUICKI明显低于A组(P<0.05)。两组之间年龄、HbA1c、FPG、TC、TG、HDL-C、LDL-C差异无统计学意义。Pearson相关分析结果显示,ET-1与体重、BMI、FINS、HOMA-IR呈显著正相关(P<0.01),与IAI、QUICKI呈显著负相关(P<0.01)。结论 T2DM合并NAFLD患者ET-1水平升高,IR程度明显加重。因此,T2DM合并NAFLD患者更需及早进行内皮功能障碍与IR干预,预防动脉粥样硬化的发生。

Objective To investigate the correlation be tween plasma endothlin - 1 and insulin resistance in patients of type 2 diabetes（T2DM） with nonalcoholic fatty liver disease（NAFLD）. Methods Totally 99 type 2 diabetes patients were divided into two groups, including 51 diabetes without NAFLD （group A） , and 48 diabetes with NAFLD （group B ）. The level of height, weight, systolic pressure （SBP） ,diastolic pressure （DBP）, plasma endothin- 1 （ET- 1 ）, fasting plasma glucose （FPG）, fasting insulin （FINS）, hemoglobin （ HbA1c ） , total cholesterol （ TC ） , triglyceride （TG） , high density lipoprotein （ HDL - C ） , low density lipoprotein （ LDL - C ） , alanine aminotransferase （ALT） , aspartic aminotransferase （AST） and glutamyhranspeptidase （GGT） were measured. Body mass index （BMI） , index of insulin resistance （HOMA -IR）, insulin action index （IAI） and quantitative insulin sensitivity check index（QUICKI） were calculated. Results The level of weight,BMI,FINS,HOMA - IR,ET - 1 ,SBP,DBP,ALT,AST,GGT in group B were significantly higher than those in group A（P 〈0.05）. And the level of IAI,QUICKI in group B was significantly lower than those in group A（P 〈0.05）. The Pearson＇s correlation analysis showed that the level of ET- 1 was positive COITelated with weight, BMI, FINS, HOMA -IR（ P 〈 0.01 ） , and was negative correlated with IAI, QUICKI（P 〈 0.01 ）. Conclusion The T2DM with NAFLD patients show an increased ET - 1 level and more severity of insulin resistance. So, these patients needs early endothelial dysfunction and insulin resistance intervention to prevent the atherosclcrosis.