2型糖尿病合并非酒精性脂肪肝病与胰岛素抵抗的相关性研究

The correlation between the type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease and insulin resistance

(1)目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝病(NAFLD)与胰岛素抵抗(IR)的相关性。(2)方法共纳入209例受试者,根据T2DM病程和NAFLD病程,将其分为单纯T2DM组(A组,62例),T2DM病程大于NAFLD病程组(B组,87例)和NAFLD病程大于T2DM病程组(C组,60例),收集临床资料并检测相关生化指标,采用己糖激酶法测定空腹血糖、放射免疫法测定空腹胰岛素,并计算反应IR的胰岛素抵抗指数(HOMA-IR),比较各组不同指标的差异。(3)结果 A组空腹胰岛素、HOMA-IR明显低于B组及C组(P<0.05)。HOMA-IR与年龄呈负相关(r=-0.255,P<0.05),与体质量指数(BMI)、糖化血红蛋白(HbA1c)、甘油三酯(TG)呈正相关(r=0.377,0.211,0.244,P均<0.05)。多元逐步回归分析显示,BMI、HbA1c、TG是HOMA-IR的独立相关因素(P均<0.05)。(4)结论 T2DM合并NAFLD患者HOMA-IR明显升高。HOMA-IR与BMI、HbA1c、TG相关。

Objective To explore the correlation between the type 2 diabetes me-llitus(T2DM)complicated with nonalcoholic fatty liver disease(NAFLD)and insu-lin resistance(IR).Methods A total of 209 patients were enrolled,according to the T2DM course and the course of NAFLD,which could be divided into simple T2DM group(group A,62 cases),the course of T2DM was greater than NAFLD course group(group B,87 cases)and NAFLD duration greater than T2DM duration group(group C,60 cases).Clinical data and biochemical parameters were collected.Fasting plasma glucose(FPG)was measured by hexokinase method.Fasting insulin(Fins)was measured by radioimmunoassay.Calculate reflect the insulin resistance index of insulin resistance(HOMA-IR),comparing the difference between the groups of different indicators.[Results In group A,fasting insulin and HOMA-IR was significantly lower than that of group B and C(P<0.05).The level of HOMA-IR was negatively correlated with age(r=-0.255,P<0.05),and was positively correlated with body mass index,glycosylated hemoglobin,triacylgyceride(r=0.377,0.211,0.244,P<0.05).Multiple stepwise regression analysis showed that body mass index,glycosylated hemoglobin,Triacylglycerides were independent related factors of the level of HOM A-IR(P<0.05).Conclusion The level of HOMA-IR is increased significantly in patients with T2DM combined with NAFLD.HOMA-IR is related to body mass index,glycosylated hemoglobin and triacylglyceride.