T2DM合并NAFLD老年患者血清miR-34a的表达水平与肝脂肪含量及胰岛素抵抗的关系

Relationship between serum miR-34a expression with liver fat content and insulin resistance in patients with T2DM complicating NAFLD

目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者血清miR-34a表达水平与肝脂肪含量(LFC)及胰岛素抵抗(IR)的关系。方法选取该院2018年7月至2020年7月收治的118例T2DM患者,根据是否合并NAFLD分为T2DM组(66例)和NAFLD组(52例)。对比两组患者一般资料和血清miR-34a相对表达水平,采用Spearman相关分析NAFLD组患者血清miR-34a相对表达水平与LFC和胰岛素抵抗指数(HOMA-IR)的相关性,采用多因素Logistic回归分析T2DM患者合并NAFLD的影响因素。结果NAFLD组患者体质量指数(BMI)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、HOMA-IR、LFC、miR-34a水平明显高于T2DM组(P<0.05);Spearman相关分析显示,NAFLD组患者血清miR-34a相对表达水平与LFC、HOMA-IR呈正相关(r=0.741、0.591,P<0.05);多因素Logistic回归分析显示,BMI(OR=1.544,95%CI:1.071~2.227)、ALT(OR=1.083,95%CI:1.029~1.140)、FINS(OR=1.446,95%CI:1.036~2.320)、HOMA-IR(OR=1.348,95%CI:1.064~2.653)、LFC(OR=1.401,95%CI:1.024~1.916)、miR-34a(OR=1.143,95%CI:0.805~2.535)为T2DM患者合并NAFLD的独立危险因素(P<0.05)。结论T2DM合并NAFLD患者血清miR-34a相对表达水平明显上升,与LFC和HOMA-IR呈正相关,miR-34a为T2DM合并NAFLD的独立危险因素。

Objective To investigate the relationship between serum miR-34a expression level with the liver fat content(LFC)and insulin resistance(IR)in the patients with type 2 diabetes mellitus(T2DM)complicating non-alcoholic fatty liver(NAFLD).Methods A total of 118 T2DM patients admitted to this hospital from July 2018 to July 2020 were selected and divided into the T2DM group(66 cases)and NAFLD group(52 cases)according to whether comlicating NAFLD.The general data and serum miR-34a relative expression level were compared between the two groups.The Spearman correlation analysis was used to analyze the correlation between the serum miR-34a relative expression level in the NAFLD group with LFC and HOMA-IR,and the multivariate Logistic regression was adopted to analyze the influencing factors of T2DM complicating NAFLD.Results The body mass index(BMI),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT),fasting insulin(FINS),glycated hemoglobin(HbA1c),HOMA-IR,LFC,miR-34a in the NAFLD group were significantly higher than those in the T2DM group(P<0.05);the Spearman correlation analysis showed that serum miR-34a relative expression level in the NAFLD group was positively correlated with LFC and HOMA-IR(r=0.741,0.591,P<0.05);the multivariate Logistic regression analysis showed that BMI(OR=1.544,95%CI:1.071-2.227),ALT(OR=1.083,95%CI:1.029-1.140),FINS(OR=1.446,95%CI:1.036-2.320),HOMA-IR(OR=1.348,95%CI:1.064-2.653),LFC(OR=1.401,95%CI:1.024-1.916),miR-34a(OR=1.143,95%CI:0.805-2.535)were the independent risk factors for T2DM complicating NAFLD(P<0.05).Conclusion The relative expression level of serum miR-34a in the patients with T2DM complicating NAFLD is significantly increased,which is positively correlated with LFC and HOMA-IR.miR-34a is an independent risk factor for T2DM complicating NAFLD.