老年T2DM伴非酒精性脂肪肝病患者nesfatin-1、ADRP水平与外周单核细胞M1/M2失衡的关系

Relationship between levels of nesfatin-1,ADRP and imbalance of peripheral monocyte M1/M2 in elderly T2DM patients with nonalcoholic fatty liver disease

目的探究老年2型糖尿病(T2DM)伴非酒精性脂肪肝病(NAFLD)患者人新饱食分子蛋白-1(nesfatin-1)、脂肪分化相关蛋白(ADRP)水平与外周单核细胞M1/M2失衡的关系。方法选择2019年2月至2021年2月黑龙江省佳木斯市中心医院收治的143例T2DM患者,根据是否发生NAFLD分为非NAFLD组(n=79)和NAFLD组(n=64),比较两组血清nesfatin-1、ADRP水平,比较两组外周血单核细胞M1/M2相关细胞因子mRNA水平,采用Pearson检验分析nesfatin-1、ADRP水平与NAFLD组患者外周单核细胞M1/M2相关细胞因子的关系,采用Logistic回归分析T2DM患者nesfatin-1、ADRP水平与NAFLD患病风险的关系。结果与非NAFLD组比较,NAFLD组血清nesfatin-1、ADRP水平增高(P<0.05);NAFLD组肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)mRNA水平增高(P<0.05),白细胞介素10(IL-10)mRNA水平减少(P<0.05)。Pearson检验分析显示,nesfatin-1、ADRP水平与NAFLD组患者外周单核细胞TNF-α、IL-6 mRNA水平呈正相关(P<0.05),nesfatin-1、ADRP水平与NAFLD组患者外周单核细胞IL-10 mRNA水平呈负相关(P<0.05);Logistic回归分析显示,血清nesfatin-1高水平(O^R=3.325,95%CI=1.481~11.811)、血清ADRP高水平(O^R=3.862,95%CI=1.732~13.954)是T2DM伴非酒精性脂肪肝病的危险因素(P<0.05)。结论高水平nesfatin-1、ADRP是T2DM伴非酒精性脂肪肝病的危险因素,其表达水平与外周单核细胞M1/M2失衡有着密切相关性,有望将nesfatin-1和ADRP作为患者抗炎治疗干预的新靶点。

【Objective】To explore the relationship between the level of human new satiety molecular protein-1(nesfatin-1)and adipocyte differentiation related protein(ADRP)and the imbalance of M1/M2 in peripheral blood mononuclear cells in elderly patients with type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD).【Methods】A total of 143 patients with T2DM admitted to our hospital from February 2019 to February 2021 were divided into non-NAFLD group(n=79)and NAFLD group(n=64)according to whether they had NAFLD.The levels of serum nesfatin-1 and ADRP were compared between the two groups,and the mRNA levels of M1/M2 related cytokines in peripheral blood mononuclear cells of the two groups were compared.The relationship between ADRP level and M1/M2 related cytokines in peripheral monocytes of patients with NAFLD was analyzed.The relationship between nesfatin-1,ADRP level and the risk of nonalcoholic fatty liver disease was analyzed by logistic regression.【Results】The levels of serum nesfatin-1 and ADRP in NAFLD group were significantly higher than those in non-NAFLD group(P<0.05).Compared with non-NAFLD group,the level of TNF-α,IL-6 mRNA increased significantly in NAFLD group(P<0.05),while the level of IL-10 mRNA decreased significantly(P<0.05).Pearson test analysis showed that the levels of nesfatin-1 and ADRP were positively correlated with the levels of TNF-α,IL-6 mRNA in peripheral monocytes of patients with NAFLD(P<0.05),while nesfatin-1 and ADRP levels were negatively correlated with IL-10 mRNA level of peripheral monocytes in NAFLD group(P<0.05).Logistic regression analysis showed that high level of serum nesfatin-1(O^R=3.325,95%CI=1.481~11.811)and high level of serum ADRP((O^R=3.862,95%CI=1.732~13.954)were risk factors of T2DM with NAFLD(P<0.05).【Conclusion】High levels of nesfatin-1 and ADRP are risk factors for T2DM with NAFLD,and their expression levels are closely related to the imbalance of M1/M2 in peripheral monocytes.It is expected that nesfatin-1 and ADRP can be used as new targets for anti-inflammatory therapy in patients with T2DM.