2型糖尿病合并代谢相关脂肪性肝病血浆预测标志物的研究

The value of plasma biological indicators in predicting type 2 diabetes mellitus patients combined with metabolic associated fatty liver disease

目的 探讨血浆致动脉粥样硬化指数(AIP)、单核细胞/高密度脂蛋白比值(MHR)及血尿酸/高密度脂蛋白胆固醇比值(UHR),预测T2DM合并代谢相关脂肪性肝病(MAFLD)的价值。方法 选取2021年11月至2022年8月于德驭医疗马鞍山总医院内分泌科治疗的T2DM患者156例,根据肝脏彩色超声检查分为单纯T2DM组(n=67)及T2DM合并MAFLD组(T2DM+MAFLD,n=89)。结果 与T2DM组比较,T2DM+MAFLD组BMI、WHR、FPG、Hb A1c、TG、MHR、UHR及AIP升高,HDL-C降低(P<0.05)。Pearson相关分析显示,AIP与BMI、WHR、FPG、Hb A1c及LDL-C呈正相关(P<0.05)。Logistic回归分析显示,BMI、AIP是T2DM合并MAFLD的影响因素。受试者工作特征曲线分析显示,BMI、AIP预测T2DM合并MAFLD的曲线下面积为0.702、0.680,敏感度为68.5%、59.6%,特异度为68.7%、71.6%。结论 BMI、AIP与T2DM合并MAFLD相关,可作为临床预测T2DM合并MAFLD的指标。

Objective To observe the value of atherogenic index of plasma(AIP),peripheral bloodmonocyte/high‐density lipoprotein cholesterolratio(MHR)and serum uricacid/high‐densitylipoprotein cholesterol ratio(UHR)in predicting metabolic associated fatty liver disease(MAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods 156 T2DM patients who were treated in Maanshan General Hospital of Ranger‐Duree Healthcare from November 2021 to August 2022 were selected and divided into simple T2DM group(n=67)and T2DM combined with MAFLD group(T2DM+MAFLD,n=89)based on liver color ultrasound examination.Results Compared with T2DM group,BMI,WHR,FPG,HbA1c,TG,AIP,MHR and UHR were higher in T2DM+MAFLD group,while the level of HDL‐C was lower(P<0.05).Pearson correlation analysis showed that AIP was positively correlated with BMI,WHR,FPG,HbA1c and LDL‐C(P<0.05).Logistic regression analysis showed that BMI and AIP were the influencing factors of T2DM combined with MAFLD.The analysis of the working characteristic curve of the subjects showed that the area under the curve of BMI and AIP in predicting for T2DM combined with MAFLD were 0.702 and 0.680,with sensitivity of 68.5%and 59.6%,specificity of 68.7%and 71.6%respectively.Conclusions BMI and AIP are associated with T2DM combined with MAFLD,and can be used as clinical predictive markers.