非酒精性脂肪肝合并T2DM患者血清IGF-1、IGF-2水平与胰岛素抵抗的相关性分析

Analysis of the Correlation between Serum Levels of IGF-1 and IGF-2 and Insulin Resistance in Patients with Nonalcoholic Fatty Liver and T2DM

目的:探究非酒精性脂肪肝(NAFLD)合并2型糖尿病(T2DM)患者血清IGF-1、IGF-2水平与胰岛素抵抗的相关性。方法:回顾性分析2015年5月-2017年7月本院收治的NAFLD合并T2DM患者90例的临床资料,按胰岛素抵抗指数(HOMA-IR)分级分为轻度组(34例)、中度组(30例)、重度组(26例)。比较各组患者肝功能指标[天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、谷丙转氨酶(ALT)]、血清胰岛素样生长因子[胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子-2(IGF-2)]差异;分析HOMA-IR指标与其余各指标之间的相关性。结果:三组患者AST、GGT、ALT水平比较结果显示,轻度组<中度组<重度组,组间比较差异均有统计学意义(P<0.05);三组患者IGF-1、IGF-2水平比较结果显示,轻度组<中度组<重度组,组间比较差异均有统计学意义(P<0.05);Spearman相关分析结果表明,胰岛素抵抗程度与AST、GGT、ALT、IGF-1、IGF-2指标均呈显著正相关性(P<0.05)。结论:NAFLD合并T2DM患者体内胰岛素抵抗程度与肝功能指标、IGF-1、IGF-2水平均有紧密关联,可为临床诊治提供参考与指导。

Objective:To investigate the correlation between serum levels of IGF-1 and IGF-2 and insulin resistance in patients with nonalcoholic fatty liver disease(NAFLD)and type 2 diabetes mellitus(T2DM).Method:Ninety patients with NAFLD and T2DM admitted to our hospital from May 2015 to July 2017 were retrospectively analyzed.They were divided into mild group(34 cases),moderate group(30 cases)and severe group(26 cases)according to the HOMA-IR classification.The differences of liver function indicators[aspartate aminotransferase(AST),glutamyl transpeptidase(GGT),glutamic alanine transaminase(ALT)],serum insulin-like growth factor[insulin-like growth factor-1(IGF-1),insulin-like growth factor-2(IGF-2)]in each group were compared,and the correlation between HOMA-IR indicators and other indicators was analyzed.Result:The comparison results of AST,GGT and ALT levels in the three groups showed that the mild group<the moderate group<the severe group,and the comparison between the groups had statistical significance(P<0.05).The comparison results of IGF-1 and IGF-2 levels in the three groups showed that the mild group<the moderate group<the severe group,and the comparison between the groups had statistical significance(P<0.05).Spearman correlation analysis showed that the degree of insulin resistance was positively correlated with AST,GGT,ALT,IGF-1 and IGF-2(P<0.05).Conclusion:The degree of insulin resistance in patients with NAFLD and T2DM is closely related to liver function index,IGF-1 and IGF-2 levels,which can provide reference and guidance for clinical diagnosis and treatment.