糖尿病合并MAFLD患者外周血Chemerin与糖脂代谢、内脏脂肪、氧化应激及炎症指标的关系

Relationship of peripheral blood Chemerin with glucose and lipid metabolism,visceral fat,oxidative stress and inflammatory indexes in diabetic patients with MAFLD disease

目的探究糖尿病(diabetes mellitus,DM)合并代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)患者外周血Chemerin与糖脂代谢、内脏脂肪、氧化应激及炎症指标的关系。方法选取DM患者(DM组)84例,DM合并MAFLD患者(DM合并MAFLD组)124例,同期体检健康者(健康对照组)62例。比较3组外周血Chemerin及与糖脂代谢、内脏脂肪、氧化应激及炎症指标的相关性;评估外周血Chemerin对DM合并MAFLD的预测价值。结果DM合并MAFLD组糖化血红蛋白(glucated haemoglobin A1c,HbA1c)、空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 h plasma glucose,2 hPG)、空腹血清胰岛素浓度(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、Chemerin、高敏C反应蛋白(high-sensitive C-reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)、内脏脂肪面积(visceral fat area,VFA)、丙二醛(malonaldehyde,MDA)水平高于对照组和DM组,高密度脂蛋白胆固醇(high-level level of lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽(glutathione,CSH)水平低于对照组和DM组,DM组HbA1c、FPG、2 hPG、FINS、HOMA-IR、TC、TG、Chemerin、hs-CRP、TNF-α、IL-6、VFA、MDA水平高于对照组,HDL-C、LDL-C、SOD、CSH水平低于对照组,差异有统计学意义(P<0.05)。相关性分析显示,外周血Chemerin与TC、TG、hs-CRP、TNF-α、IL-6、VFA及MDA均呈显著正相关(r=0.862、0.784、0.657、0.835、0.827、0.857、0.847,P<0.01),与HDL-C、LDL-C、SOD、CSH呈显著负相关(r=-0.300、-0.362、-0.513、-0.630,P<0.01)。多元逐步回归分析显示,TC、TG、IL-6、VFA及SOD均为Chemerin影响因素。结论Chemerin与IL-6、VFA及SOD关系密切,参与DM合并MAFLD的病理生理过程。

Objective To explore the relationship of peripheral blood Chemerin with glucose and lipid metabolism,visceral fat,oxidative stress and inflammatory indexes in patients with diabetes mellitus(DM)complicated with metabolic associated fatty liver disease(MAFLD).Methods A total of 84 DM patients(DM group),124 DM patients with MAFLD(DM combined MAFLD group),and 62 healthy physical examinees(healthy control group)were selected.The peripheral blood Chemerin and its correlation with glucose and lipid metabolism,visceral fat,oxidative stress and inflammatory indexes among three groups were compared in the three groups.The predictive value of peripheral blood Chemerin in DM complicated with MAFLD was evaluated.Results The levels of glucated haemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2 h plasma glucose(2 hPG),fasting insulin(FINS),homeostasis model assessment for insulin resistance(HOMA-IR),total cholesterol(TC),triacylglycerol(TG),Chemerin,high-sensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),visceral fat area(VFA)and malonaldehyde(MDA)in DM combined with MAFLD group were higher than those in control group and DM group,while the levels of high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),superoxide dismutase(SOD),and glutathione(CSH)were lower than those in the control group and DM group.The levels of HbA1c,FPG,2 hPG,FINS,HOMA-IR,TC,TG,Chemerin,hs-CRP,TNF-α,IL-6,VFA and MDA were higher in the DM group than in the control group,while the levels of HDL-C,LDL-C,SOD and CSH were lower than those of the control group,and the differences were statistically significant(P<0.05).Correlation analysis showed that Chemerin in peripheral blood was significantly positively correlated with TC,TG,Hs-CRP,TNF-α,IL-6,VFA and MDA(r=0.862,0.784,0.657,0.835,0.827,0.857,0.847,P<0.01),and was significantly negatively correlated with HDL-C,LDL-C,SOD,and CSH(r=-0.300,-0.362,-0.513,-0.630,P<0.01).Multiple stepwise regression analysis showed that TC,TG,IL-6,VFA and SOD were all influencing factors of Chemerin.Conclusion Chemerin is closely related to IL-6,VFA and SOD,and is involved in the pathophysiological process of DM combined with MAFLD.