血清C1q/肿瘤坏死因子相关蛋白12与非酒精性脂肪肝病和2型糖尿病的相关性

Relationship between serum C1q/tumor necrosis factor-associated protein 12 with nonalcoholic fatty liver disease and type 2 diabetes mellitus

目的探讨血清C1q/肿瘤坏死因子相关蛋白12(CTRP12)与非酒精性脂肪肝病(NAFLD)和2型糖尿病(T2DM)的相关性。方法收集2019年3月至2020年6月在苏州大学附属第一医院内分泌科和体检中心选取新诊断的T2DM患者和正常糖耐量(NGT)受试者。结合超声检查结果,分为单纯T2DM组(T2DM不合并NAFLD者)、T2DM+NAFLD组(T2DM合并NAFLD者)、单纯NGT组(NGT不合并NAFLD者)和NGT+NAFLD组(NGT合并NAFLD者)。观察记录一般临床资料,测定代谢相关指标及肝酶水平,并测量血清CTRP12浓度。采用Pearson法分析血清CTRP12与其他指标的相关性,采用二元logistic回归法分析发生NAFLD的独立影响因素。结果125例T2DM患者和121例NGT纳入研究,其中单纯T2DM组55例、T2DM+NAFLD组70例、单纯NGT组74例、NGT+NAFLD组47例。NGT+NAFLD组的血清CTRP12水平最高,为(338.58±68.66)pg/ml,而单纯T2DM组最低,为(264.57±56.65)pg/ml;单纯NGT组和T2DM+NAFLD组的血清CTRP12差异无统计学意义(P>0.05)。血清CTRP12与空腹血糖(r=-0.248)、糖化血红蛋白(r=-0.338)、胰岛素(r=-0.274)、稳态模型胰岛素抵抗指数(r=-0.302)呈负相关(均P<0.01),与肌酐(r=0.145)呈正相关(P<0.05),而与其他变量不具有相关性(均P>0.05)。CTRP12、腰围、丙氨酸氨基转移酶、甘油三酯增高为NAFLD的独立危险因素(P<0.01)。结论在T2DM患者中,血清CTRP12降低。血清CTRP12增高可能是NAFLD的独立危险因素。

Objective To investigate the relationship between serum C1q/tumor necrosis factor related protein 12(CTRP12)with nonalcoholic fatty liver disease(NAFLD)and type 2 diabetes mellitus(T2DM).Methods From March 2019 to June 2020,patients with newly diagnosed T2DM and age-and sex-matched people with normal glucose tolerance(NGT)were selected respectively from the First Affiliated Hospital of Soochow University.The subjects were divided into four groups according to the results of ultrasound images:people with T2DM but without NAFLD was assigned to T2DM group,with T2DM and NAFLD assigned to T2DM+NAFLD group;the rest people with normal glucose tolerance(NGT)were divided into NGT group and NGT+NAFLD group according to without or with NAFFLD.Clinical data were collected and serum CTRP12 concentration was detected by enzyme-linked immuno sorbent assay(ELISA).Pearson correlation was used to analyze the correlation between CTRP12 and other variables,and binary logistic regression was used to analyze the independent influencing factors of NAFLD.Results One hundred and twenty five patients with newly diagnosed T2DM and 121 people with NGT were enrolled respectively:people with T2DM but without NAFLD was assigned to T2DM group(n=55),with T2DM and NAFLD assigned to T2DM+NAFLD group(n=70),NGT group(n=74)and NGT+NAFLD group(n=47).The level of serum CTRP12 was the highest in NGT+NAFLD group[(338.58±68.66)pg/ml],and the lowest in T2DM group[(264.57±56.65)pg/ml].There was no difference between serum CTRP12 in NGT group and T2DM+NAFLD group(P>0.05).Serum CTRP12 was negatively correlated with fasting plasms glucose(FPG),glycated hemoglobin(HbA1c),fasting insulin(FIN),insulin resistance(HOMA-IR)(r=-0.248,-0.338,-0.274 and-0.302,respectively;P<0.01).Binary logistic regression showed that CTRP12,waist circumference(WC),alanine aminotransferase(ALT),triglyceride(TG)were independent risk factors of NAFLD(P<0.01).Conclusions Serum CTRP12 decreases in people with T2DM.The increase of CTRP12 might be an independent risk factor of NAFLD.