文章摘要
桑谊荃,马向华,倪 娟,谢 媛,李晓娜,俞 岭.视黄醇结合蛋白4与新诊断2型糖尿病合并非酒精性脂肪肝的关系研究[J].南京医科大学学报,2013,(5):646~650
视黄醇结合蛋白4与新诊断2型糖尿病合并非酒精性脂肪肝的关系研究
The correlation between retinol binding protein 4 and nonalcoholic fatty liver disease in newly-diagnosed type 2 diabetes mellitus
投稿时间:2012-12-07  
DOI:10.7655/NYDXBNS20130516
中文关键词: 2型糖尿病  非酒精性脂肪肝  视黄醇结合蛋白4
英文关键词: type 2 diabetes mellitus  nonalcoholic fatty liver disease  retinol binding protein 4
基金项目:江苏省中医局项目(LZ11080)
作者单位
桑谊荃 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
马向华 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
倪 娟 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
谢 媛 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
李晓娜 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
俞 岭 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
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中文摘要:
      目的:探讨新诊断的2型糖尿病(type 2 diabetes mellitus,T2DM)合并非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的代谢特征及与视黄醇结合蛋白4(retinol binding protein 4,RBP4)的关系。方法:收集新诊断的T2DM住院患者216例,根据是否合并NAFLD分为T2DM伴有NAFLD组144例和T2DM不伴NAFLD组72例。测量两组患者血压?体质指数(body mass index,BMI)?血脂[总胆固醇(total cholesterol,TC)?甘油三酯(triglyceride,TG)?高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)?低密度脂蛋白胆固醇(low density lipoprotein cholestorol,LDL-C)?脂蛋白a(lipoprotein a,Lp-a)]?空腹血糖(fasting blood glucose,FBG)?空腹胰岛素(fasting insulin,FINS)?糖化血红蛋白(HbA1c)?血尿酸(uric acid,UA)?肝功能[γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,γ-GGT)?丙氨酸转氨酶(alanine transarninase,ALT)?天门冬氨酸转氨酶(aspartate transarninase,AST)]及RBP4,比较上述指标在两组间有无差异,并对相关指标做Logistic回归或Pearson相关分析。结果:新诊断的T2DM伴有NAFLD患者的BMI?收缩压?舒张压均高于T2DM不伴NAFLD组,较正年龄?性别?BMI后,T2DM伴NAFLD患者的TG?TC?FINS?胰岛素抵抗指数?γ-GGT?ALT?UA?RBP4显著高于T2DM不伴NAFLD组(P < 0.05)。2组FBG?HbA1c?HDL-C?LDL-C?Lp-a?AST在较正年龄?性别?BMI后差异无统计学意义(P > 0.05)。Logistic回归分析发现RBP4?BMI?ALT是新诊断的T2DM合并NAFLD的独立危险因素。T2DM合并NAFLD组的RBP4与胰岛素抵抗指数?HbA1c?FINS?γ-GGT?UA显著相关(P < 0.05)。结论:新诊断的T2DM伴有NAFLD较不伴NAFLD患者存在明显的胰岛素抵抗,并与代谢综合征组分(肥胖?高血压?高脂血症?高尿酸血症)相伴发生;RBP4及BMI?ALT在预测T2DM合并NAFLD风险方面有重要临床价值。
英文摘要:
      Objective:To investigate the metabolic characteristics of newly-diagnosed type 2 diabetes with nonalcoholic fatty liver disease(NAFLD) and the correlation between retinol binding protein 4 in newly-diagnosed type 2 diabetes with nonalcoholic fatty liver disease. Methods:A total of 216 patients with newly-diagnosed type 2 diabetes were enrolled in this study. They were divided into two groups according to with or without NAFLD. We compared the blood pressure,body mass index (BMI),blood lipids [TC,TG,HDL, LDL, Lp (a)], fasting glucose, fasting insulin, HbA1c,uric acid, liver function and retinol binding protein 4(RBP4). Logistic regression and Pearson correlation were performed to analyze the related factors. Results:The levels of BMI, systolic blood pressure, diastolic blood pressure were much higher in T2DM with NAFLD group than T2DM without NAFLD group. After adjustment of age,sex and BMI, the levels of triglyceride, total cholesterol, fasting insulin, insulin resistance index (HOMA-IR),ALT,γ-GGT, uric acid,RBP4 were significant higher in newly-diagnosed type 2 diabetes with NAFLD disease (P < 0.05). In logistic regression analysis,BMI,ALT and RBP4 were significant and independent predictors of newly-diagnosed type 2 diabetes with NAFLD(P < 0.05). RBP4 was significantly correlated with HOMA-IR,HbA1c,FINS,γ-GGT,UA (P < 0.05). Conclusion: The results suggest that newly-diagnosed type 2 diabetes with NAFLD displayed with the components of metabolic syndrome RBP4 may be an important indicator of nonalcoholic fatty liver disease in newly-diagnosed type 2 diabetes.
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