2型糖尿病合并非酒精性脂肪性肝病患者IGF-1与胰岛素抵抗关系
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淮安市科技局资助项目(HAS2010027)


Relationship between insulin-like growth factor-1 and insulin resistance in type 2 diabetic patients with nonalcoholic fatty liver disease
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    摘要:

    目的:研究2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者胰岛素样生长因子-1(IGF-1)与胰岛素抵抗的关系-方法:采用化学发光分析法测定46例T2DM合并NAFLD患者-45例T2DM患者-42例健康对照者血清IGF-I-生长激素(GH)水平,同时测定所有对象的空腹血糖(FPG)-空腹胰岛素(FINS)-胆固醇(CH)-甘油三酯(TG)-高密度脂蛋白胆固醇(HDL-C)-低密度脂蛋白胆固醇(LDL-C)-丙氨酸氨基转移酶(ALT)-门冬氨酸氨基转移酶(AST)和-酌-谷氨酰转肽酶(GGT)的水平,并同时行肝脏B超检查-用胰岛素抵抗指数(HOMA-IR)评价胰岛素抵抗情况-结果:T2DM合并NAFLD组IGF-1[(83.49 ± 43.50)ng/ml],明显低于T2DM组[(130.34 ± 57.21) ng/ml]及对照组[(182.20 ± 57.15) ng/ml,P均 < 0.05];T2DM合并NAFLD组的HOMA-IR(5.70 ± 2.80)高于T2DM组(2.82 ± 1.53)及对照组(1.24 ± 0.45,P均 < 0.05);T2DM合并NAFLD组的ALT-AST-GGT-TG-CH-LDL-C高于T2DM组及对照组(P均 < 0.05);T2DM合并NAFLD组和T2DM组的TG-CH-LDL-C均高于对照组(P均 < 0.05);相关性分析显示,IGF-1与HOMA-IR呈负相关(r值为-0.387,P < 0.05)-结论:T2DM合并NAFLD患者血清IGF-1水平显著下降,与胰岛素抵抗呈负相关,可能在疾病的发生发展中具有重要作用-

    Abstract:

    Objective:To study the relationship between the insulin-like growth factor 1(IGF-1)and insulin resistance(IR)in type 2 diabetic patients(T2DM)with nonalcoholic fatty liver disease(NAFLD). Methods:The levels of IGF-1,growth hormone(GH) in blood serum of 46 T2DM patients with NAFLD, 45 T2DM patients, 42 healthy persons were determined by chemiluminescence. The levels of fasting plasma glucose(FPG),fasting insulin(FINS),cholesterol(CH),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),alaninea minotransferase(ALT),aspartate aminotransferase(AST) and -酌-glutamy transpeptidase (GGT) were determined. Ultrasonic inspection of liver was performed. Insulin resistance was assessed by insulin resistance index(HOMA-IR). Results:The level of IGF-1 in T2DM group with NAFLD was lower than that of T2DM group without NAFLD and healthy control group(83.49 ± 43.50 vs 130.34 ± 57.21,182.20 ± 57.15;P < 0.05). The level of HOMA-IR in T2DM group with NAFLD were higher than that of T2DM group without NAFLD and normal control subjects(5.70 ± 2.80 vs 2.82 ± 1.53,1.24 ± 0.45;P < 0.05). The levels of ALT,AST,GGT,TG,CH,LDL-C in group of T2DM with NAFLD were higher than that in other two groups(P < 0.05). The levels of TG,CH,LDL-C in the groups of T2DM with NAFLD and T2DM without NAFLD were higher than that of control subjects(P < 0.05). Correlation analysis showed that the levels of IGF-1 were negatively correlated with HOMA-IR(r = -0.387,P < 0.05). Conclusion:The level of IGF-1 significantly decreased in T2DM patients with NAFLD. Serum IGF-1 was negatively correlated with insulin resistance. Serum IGF-1 may play an important role in the development of T2DM with NAFLD.

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张秀梅,胡长军,张 红,周 莉,崔兆辉,陆卫平.2型糖尿病合并非酒精性脂肪性肝病患者IGF-1与胰岛素抵抗关系[J].南京医科大学学报(自然科学版),2011,(8):1220-1223

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  • 收稿日期:2011-03-17
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