生长激素与2型糖尿病合并非酒精性脂肪性肝病关系的研究

The effect and significance of growth hormone in type 2 diabetes mellitus with non-alcoholic fatty liver disease

目的探讨生长激素(GH)与T2DM合并非酒精性脂肪性肝病(NAFLD)发生发展的关系及意义。方法选取2018年12月至2019年5月于蚌埠医学院第一附属医院内分泌科住院的T2DM患者94例,其中单纯T2DM患者(T2DM组)41例,合并NAFLD患者(NAFLD组)53例。分析两组GH、IGF-1、FC-P、TG等以及GH与血糖、血脂及肝酶学指标的相关性。结果NAFLD组GH低于T2DM组[0.13(0.05,0.31)vs 0.51(0.13,1.06)μg/L,P<0.05],TG、FC-P高于T2DM组[2.35(1.98,3.27)vs 1.18(0.94,1.96)mmol/L,1.58(0.72,2.84)vs 0.87(0.51,2.15)ng/ml,P<0.05]。相关性分析显示,GH与Fibroscan中受控衰减参数呈负相关(r=-0.47,P<0.05),NAFLD组GH与IGF-1呈正相关(r=0.58,P<0.05),与FC-P呈负相关(r=-0.36,P<0.05);IGF-1与FC-P呈负相关(r=-0.40,P<0.05),表明GH对T2DM合并NAFLD患者可能通过GH/IGF-1轴发挥保护作用。结论血清GH水平与T2DM合并NAFLD相关,GH减少或缺乏可促进T2DM患者发生NAFLD,补充GH可能减缓NAFLD进展。

Objective To explore the effect and significance of growth hormone(GH)in type 2 diabetes mellitus(T2 DM)with non-alcoholic fatty liver disease(NAFLD).Methods 94 T2 DM patients were selected including 41 without NAFLD and 43 with NAFLD.The diagnosis of NAFLD was conducted using Fibroscan.The indicators of GH,insulin-like growth factor 1(IGF-1),fasting C-peptide(FC-P)glucose,lipids and liver enzymes were measured.Results The level of GH in T2 DM with NAFLD was lower than that of T2 DM alone[0.13(0.05,0.31)vs 0.51(0.13,1.06)μg/L,P<0.05].TG and FC-P levels were higher in T2 DM patients with NAFLD than those without NAFLD[2.35(1.98,3.27)vs 1.18(0.94,1.96)mmol/L,1.58(0.72,2.84)vs 0.87(0.51,2.15)ng/ml,P<0.05].The correlation analysis showed a negative correlation between GH and the CAP value of Fibroscan(r=-0.47,P<0.05),a positive correlation between GH and IGF-1(r=0.58,P<0.05),a positive correlation between GH and FC-P(r=-0.36,P<0.05),and a positive correlation between IGF-1 and FC-P(r=-0.40,P<0.05).Conclusion Serum GH levels are associated with T2 DM combined with NAFLD.Reduced or lack of GH may promote NAFLD in T2 DM patients.GH supplementation may slow down the progression of NAFLD in T2 DM patients.