血清鸢尾素水平与2型糖尿病合并非酒精性脂肪肝病的相关性研究

Study on Correlation between Serum Irisin Level and Type 2 Diabetes Mellitus Combined with Nonalcoholic Fatty Liver Disease

目的探讨血清鸢尾素水平与2型糖尿病(T2DM)合并非酒精性脂肪肝病(NAFLD)的相关性。方法选取2013年5月—2016年12月收治的184例T2DM患者和60例同期体检正常者(对照组)作为研究对象。根据T2DM患者是否合并NAFLD分为A组(合并NAFLD)102例和B组(未合并NAFLD)82例。记录所有研究对象的性别、年龄、体重指数等一般临床资料,以及血清鸢尾素等相关临床指标,并比较3组研究对象上述资料的差异性。结果A组体重指数高于对照组和B组,且病程长于B组(P<0.05)。A组和B组的甘油三酯(TG)、总胆固醇、低密度脂蛋白胆固醇、空腹血糖(FPG)、餐后2 h血糖、糖化血红蛋白和血尿酸(UA)水平均显著高于对照组,而高密度脂蛋白胆固醇(HDL-C)和鸢尾素水平低于对照组(P<0.05)。A组的TG、FPG和UA水平高于B组,而HDL-C和鸢尾素水平低于B组(P<0.05)。体重指数过高、病程较长、HDL-C和鸢尾素水平过低以及UA水平过高均为T2DM患者发生NAFLD的独立危险因素(P<0.05)。结论鸢尾素可作为评估T2DM患者NAFLD发生和进展的主要临床指标。

Objective To investigate correlation between serum irisin level and type 2 diabetes mellitus （T2DM） with nonalcoholic fatty liver disease （NAFLD）. Methods A total of 184 patients with T2DM and 60 normal people taking physical examinations （control group） during January 2013 and December 2016 were recruited in this study, and the T2DM patients were divided into group A （ n =102, combined with NAFLD） and group B （ n =82, without NAFLD） according to whether or not having NAFLD. General conditions such as gender, age and body mass index and clinical indicators such as serum irisin were recorded, and the differences in the above indexes were compared among three groups. Results In group A, value of body mass index was higher than those in control group and group B, and course of disease was longer than that in group B （ P 〈0.05）. In group A and B, levels of triglyceride （TG）, total cholesterol, low density lipoprotein cholesterol, fasting blood glucose （FPG）, 2 h postprandial blood glucose, glycosylated hemoglobin and serum uric acid （UA） were significantly higher, while levels of high-density lipoprotein cholesterol （HDL-C） and irisin levels were significantly lower than those in control group （ P 〈0.05）. In group A, TG, FPG and UA levels were significantly higher, while HDL-C and irisin levels were significantly lower than those in group B （ P 〈0.05）. High value of body mass index, long course of disease, low levels of HDL-C and irisin and high UA level were independent risk factors for NAFLD pathogenesy in T2DM patients （ P 〈0.05）. Conclusion Irisin may be used as main clinical indicator of assessing the pathogenesy and progression of NAFLD in T2DM patients.