T2DM并发NAFLD患者血清Nesfatin-1水平变化及相关影响研究

Analysis of T2DM to the Serum Nesfatin-1 Level Changes of Patients with NAFLD Horizontal

目的研究2型糖尿病并发非酒精性脂肪肝(Nonalcoholic fatty liver disease,NAFLD)患者血清Nesfatin-1水平变化及相关影响,为阐明其生理作用提供可靠依据。方法选取2014年1月~2016年1月延安大学附属医院内分泌科收治的2型糖尿病患者300例作为研究对象,根据患者是否并发NAFLD将其分为T2DM伴有NAFLD组150例与T2DM不伴有NAFLD组150例,另外选取同期在医院进行健康体检的150例志愿者作为对照组,比较三组患者的血清Nesfatin-1水平和相关生化指标,并监测两组2型糖尿病患者的胰岛素对抗指数。结果 BMI(kg/m2),TG(mmol/L),ALT(mmol/L)和INS(mIU/L)指标对比结果为:T2DM组(分别为22.1±2.5,2.0±0.9,22.1±10.5和11.2±4.5)和NGT组(分别为23.1±1.9,1.7±0.5,26.9±12.7和9.7±2.4)显著低于T2DM-NAFLD组(分别为26.5±3.8,3.0±2.5,31.9±11.5和14.2±6.5,P值均为0.00)。FBG(mmol/L),HbAlc(%),LDL-C(mmol/L),HOMA-IR和血清Nesfatin-1(ng/ml)指标对比结果为:T2DM组(分别为8.4±3.1,8.8±2.7,3.4±1.0,4.5±2.9和6.9±3.0)和T2DM-NAFLD组(分别为8.2±2.7,8.5±1.9,3.7±2.1,5.2±2.7和5.2±2.7)显著高于NGT组(分别为5.1±0.5,5.4±0.4,2.7±0.8,2.7±0.8和2.3±0.7,P值均为0.00)。Pearson分析发现T2DM组患者与T2DM-NAFLD组患者的血清Nesfatin-1水平呈现中度相关性(r=-0.421,P<0.05)。BMI,TG和血清Nesfatin-1水平与脂肪肝的发生有密切的联系(r=-0.402^-0.273,P=0.00~0.01)。结论血清Nesfatin-1可能参与2型糖尿病与NAFLD的发生。

Objective To study the effects of the serum Nesfatin-1 level change by type 2 diabetes in patients with Non-alcoholic fatty liver,and provides a reliable basis for its prysiological effects.Methods Selected 300 cases with type 2 diabetes mellitus in deoartment of endocrinology from January 2014 to January 2016 in Affiliated Hospital of Yan＇an University as the object of this study.According to whether the patients were combined with non-alcoholic fatty liver,the patients were divided into T2 DM with NAFLD group（150 cases）and T2 DM without NAFLD group（150 cases）.In addition,150 volunteers for healthy check-up in the hospital were selected as control group.Compared the serum Nesfatin-1 levels of three group patients,and monitored the insulin resistance index of two groups patients with type 2 diabetes.Results BMI,TG,ALT and INS of NGT（23.1±1.9,1.7±0.5,26.9±12.7 and 9.7±2.4,respectively）group and T2 DM（22.1±2.5,2.0±0.9,22.1±10.5 and 11.2±4.5,respectively）group were significantly lower than those of T2 DM-NAFLD group（26.5±3.8,3.0±2.5,31.9±11.5 and 14.2±6.5;all P value were 0.00）.FBG,HbAlc,LDL-C,HOMA-IR and Nesfatin-1 of T2 DM group（8.4±3.1,8.8±2.7,3.4±1.0,4.5±2.9 and 6.9±3.0）and T2 DM-NAFLD group（8.2±2.7,8.5±1.9,3.7±2.1,5.2±2.7 and 5.2±2.7）were significantly higher than those in serum NGT group（5.1±0.5,5.4±0.4,2.7±0.8,2.7±0.8 and 2.3±0.7,all P value were 0.00）.The serum Nesfatin-1 levels of T2 DM patients and patients with T2 DM-NAFLD had moderate correlation（r=-0.421,P0.05）by Pearson correlation analysis.BMI,TG and serum Nesfatin-1 levels were closely associated with the occurrence of fatty liver（r=-0.402--0.273;P=0.00-0.01）.Conclusion Nesfatin-1 may be involved in type 2 diabetes mellitus and the occurrence of non-alcoholic fatty liver.