血清脂肪酸结合蛋白1、正五聚蛋白3水平与2型糖尿病合并非酒精性脂肪性肝病的关系

The relationships between serum levels of fatty acid binding protein 1,pentraxin 3 and type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease

目的探讨血清脂肪酸结合蛋白1(FABP1)、正五聚蛋白3(PTX3)水平与2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的关系。方法选择79例T2DM合并NAFLD患者(NAFLD组),53例T2DM未合并NAFLD患者(无NAFLD组),61例门诊体检健康志愿者(对照组)进行研究。所有受试者均检测血清FABP1、PTX3、糖脂代谢、胰岛素抵抗和肝酶指标水平,并收集临床资料。采用Pearson相关分析血清FABP1、PTX3与糖脂代谢、胰岛素抵抗、肝酶指标的相关性,Logistic回归分析FABP1、PTX3与T2DM合并NAFLD的关系,采用受试者工作特征(ROC)曲线分析血清FABP1、PTX3诊断T2DM合并NAFLD的价值。结果NAFLD组血清FABP1、PTX3水平高于无NAFLD组和对照组,差异有统计学意义(P<0.05)。FABP1、PTX3水平与体质量指数(BMI)、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)均呈正相关(P<0.05)。Logistic回归分析显示,高脂血症、高BMI、HOMA-IR及高FABP1、PTX3水平是T2DM合并NAFLD的独立危险因素(P<0.05)。ROC曲线分析显示,FABP1、PTX3诊断T2DM合并NAFLD的AUC(95%CI)分别为0.693(0.598~0.789)、0.700(0.607~0.793)。联合检测AUC(95%CI)为0.894(0.828~0.959),联合检测的AUC明显高于各指标单独检测。结论T2DM合并NAFLD患者血清FABP1、PTX3水平均升高,高水平FABP1、PTX3与T2DM合并NAFLD的发生关系密切,可作为T2DM患者发生NAFLD的潜在诊断指标。

Objective To investigate the relationships between serum levels of fatty acid binding protein 1(FABP1),pentraxin 3(PTX3)and type 2 diabetes mellitus(T2DM)complicated with nonalcoholic fatty liver disease(NAFLD).Methods A total of 79 patients with T2DM complicated with NAFLD(NAFLD group),53 patients with T2DM without NAFLD(non-NAFLD group)and 61 healthy volunteers(control group)were selected in this study.The levels of serum FABP1,PTX3,glucose and lipid metabolism,insulin resistance and liver enzyme indexes were detected in all subjects,and clinical data were collected.The correlations of FABP1,PTX3,glucose and lipid metabolism,insulin resistance,liver enzyme indexes were analyzed by Pearson correlation.Logistic regression analysis was used to analyze the relationships between FABP1,PTX3 and T2DM complicated with NAFLD.Receiver operating characteristic(ROC)curve was used to analyze the value of FABP1 and PTX3 in the diagnosis of T2DM complicated with NAFLD.Results The levels of serum FABP1 and PTX3 in NAFLD group were higher than those in non-NAFLD group and control group(P<0.05).FABP1,PTX3 levels positively correlated with body mass index(BMI),total cholesterol(TC),insulin resistance index(HOMA-IR),alanine aminotransferase(ALT),glutamic oxaloacetic transaminase(AST)(P<0.05).Logistic regression analysis showed that hyperlipidemia,increased BMI,HOMA-IR,increased serum FABP1 and PTX3 levels were risk factors of the occurrence of T2DM complicated with NAFLD(P<0.05).ROC curve analysis for showed that the AUC(95%CI)of FABP1 and PTX3 diagnosis for T2DM complicated with NAFLD were 0.693(0.598-0.789)and 0.700(0.607-0.793)respectively.The AUC(95%CI)of combined application was 0.894(0.828-0.959),which was significantly higher than that of single application.Conclusion Serum levels of FABP1 and PTX3 increase in patients with T2DM complicated with NAFLD,and high levels of FABP1 and PTX3 closely relate to the occurrence of T2DM complicated with NAFLD,which could be used as potential indicators for the diagnosis of NAFLD.