2型糖尿病合并NAFLD患者植物甾醇摄入量与糖脂代谢的相关性

Correlation between average daily intake of phytosterols and glucolipid metabolism in type 2 diabetic patients complicated with NAFLD

目的分析2型糖尿病合并非酒精性脂肪肝患者植物甾醇日均摄入量与糖脂代谢的相关性。方法 2型糖尿病患者(A组)、2型糖尿病合并非酒精性脂肪肝患者(B组)、健康志愿者(C组)各50例。记录三组身高、体质量、BMI、收缩压、舒张压,计算每天摄入植物甾醇的均值。抽取空腹静脉血检测血糖、尿酸(UA)、尿素氮(BUN)、血清肌酐(sCr)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(HbA1c)、AST、ALT。进行糖耐量试验、胰岛素释放试验及C肽释放试验,胰岛素抵抗(IR)的评估采用胰岛素抵抗指数(HOMA-IR)。结果与A组比较,B组的BMI、TG、TC、LDL、ALT、AST、HOMA-IR、基础胰岛素分泌值高于A组(P均<0.05)。A、B组葡萄糖耐受试验、胰岛素释放试验及C肽释放试验高峰值较C组延迟。A、B组植物甾醇日均摄入量较C组下降,且B组低于A组(P均<0.05)。A、B组的植物甾醇日均摄入量与HDL均呈正相关,与BMI、TG、TC、LDL、ALT、AST、HOMA-IR值、尿酸、0、30、60、120、180 min血糖呈负相关;以植物甾醇日均摄入量为因变量,TG、HOMA-IR是植物甾醇摄入量的独立影响因素。结论 2型糖尿病合并非酒精性脂肪肝患者植物甾醇日均摄入量低于正常,可能与患者糖脂代谢紊乱的发生有关。

Objective To investigate the correlation between average daily intake of phytosterols and glucolipid metabolism in type 2 diabetic patients complicated with nonalcoholic fatty liver disease （NAFLD）.Methods Fifty cases of patients with type 2 diabetes mellitus （group A）,50 cases of patients with type 2 diabetes mellitus complicated with NAFLD （group B） and the same number of healthy volunteers （group C） were selected.Height,body mass,BMI,systolic blood pressure and diastolic blood pressure of each subject in the three groups were recorded,and the mean daily intake of phytosterols was calculated.Fasting plasma glucose,uric acid （UA）,blood urea nitrogen （BUN）,serum creatinine （sCr）,triacylglycerol （TG）,total cholesterol （TC）,high density lipoprotein （HDL）,low density lipoprotein （LDL）,glycosylated hemoglobin （HbAtc）,AST and ALT were measured.Additionally,glucose tolerance test,insulin release test and C-peptide release test were carried out,and we used homeostatic model assessment （HOME-IR） to assess insulin resistance （IR）.Results Compared with group A,BMI,TG,TC,LDL,ALT,AST,HOMA-IR and the value ofbasalinsulin secretion of group B were significantly higher （all P ＜ 0.05）.Compared with group C,graph peak of glucose tolerance test,insulin release test and C-peptide release test in group A and group B appeared later.The average daily intake of phytosterols of group A and group B decreased significantly as compared with that of group C,and the value of group B was less than that of group A （all P ＜ 0.05）.Among group A and group B,the average daily intake of phytosterols was positively correlated with HDL and negatively correlated with BMI,TG,TC,LDL,ALT,AST,HOMA-IR,UA,0,30,60,120,180 min glucose values.According to the multiple linear regression,we took the average daily intake of phytosterols as the dependent variables,TG and HOME-IR were independently associated with the amount of phytosterols.Conclusions Average daily intake of phytosterols of type 2 diabetic patients complicated with NAFLD is less than the normal,which might be correlated with glucolipid metabolism.