| 李曾一,梁新明,李星,等.血清丝氨酸蛋白酶抑制剂、内脂素、趋化素在 2型糖尿病并发非酒精性脂肪性肝病中的表达及与胰岛素抵抗的关系[J].安徽医药,2021,25(11):2265-2269. |
| 血清丝氨酸蛋白酶抑制剂、内脂素、趋化素在 2型糖尿病并发非酒精性脂肪性肝病中的表达及与胰岛素抵抗的关系 |
| Expression of serine protease inhibitors, endothelins and chemerin in T2DM patients with NAFLD and analysis of their relationship with insulin resistance |
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| DOI：10.3969/j.issn.1009-6469.2021.11.033 |
| 中文关键词: 非酒精性脂肪性肝病 糖尿病， 2型 丝氨酸蛋白酶抑制剂 内脂素 趋化素 胰岛素抵抗 |
| 英文关键词: Non-alcoholic fatty liver disease Diabetes mellitus,type 2 Serine protease inhibitors Endolipin Chemokine Insulin resistance |
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| 中文摘要: |
| 目的探讨血清丝氨酸蛋白酶抑制剂( Vaspin)、内脂素(Visfatin)趋化素( Chemerin)在 2型糖尿病( T2DM)并发非酒精性脂肪性肝病( NAFLD)病人中的表达及其与胰岛素抵抗( IR)的关系。方法、选取 2018年 1月至 2019年 8月南阳市中心医院收治的 T2DM，并发 NAFLD病人 76例作为观察组，未并发 NAFLD病人 62例作为对照组。比较两组血清 Vaspin、Visfatin、 Chemerin水平，受试者工作特征(ROC)曲线分析上述因子对 T2DM并发 NAFLD的诊断价值，并结合肝影像学诊断结果对比不同病情程度病人血清 Vaspin、Visfatin、Chemerin水平、胰岛素参数［胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)］，分析各血清因子与胰岛素参数关联性及 T2DM并发 NAFLD病情程度的影响或关联作用因素。结果观察组血清 Vaspin［(82.03±12.46) ng/L比( 70.81±11.22)ng/L］、 Visfatin［(39.58±6.90)μg/mL比( 33.27±5.73)μg/mL］、 Chemerin［(53.37±8.61)ng/L比( 45.39±8.02)ng/L］水平及 HOMA-IR［( 2.71±0.67)比( 1.36±0.54)］高于对照组( P<0.05)； Chemerin诊断 T2DM并发 NAFLD的 AUC值最大，0.758。随 T2DM并发 NAFLD病情加重血清 Vaspin、Visfatin、Chemerin、HOMA-IR呈升高趋势， ISI呈降低趋势( P<0.05)。血Vaspin、Visfatin、Chemerin与 HOMA-IR呈正相关，与 ISI呈负相关(P<0.05)。BMI、WHR、血清 Vaspin、Visfatin、Chemerin、HOMAIR、ISI是 T2DM并发 NAFLD病情程度的独立影响或关联作用因素( P<0.05)。结论 T2DM并发 NAFLD病人存在血清 Vaspin、 清为Visfatin、Chemerin异常表达情况，且表达水平与 IR关系密切，可能通过诱导 IR间接参与 T2DM并发 NAFLD的发病发展过程。 |
| 英文摘要: |
| Objective To investigate the expressions of serum serine protease inhibitors (Vaspin), endolipin (Visfatin) and chemokine (Chemerin) in patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) and their with insulin resistance (IR).Methods T2DM patients admitted to Nanyang Central Hospital from January 2018 to August 2019 were enrolled. A totalof 76patients complicated with NAFLD were selected as the observation group, and 62 patients without NAFLD were selected as the control group. The serum levels of Vaspin, Visfatin, and Chemerin were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the above factors on T2DM complicated with NAFLD. Combined with theresults of liver imaging diagnosis, the serum Vaspin, Visfatin, Chemerin levels and insulin parameters [insulin resistance index (HOMAIR), insulin sensitivity index (ISI)] of patients with different levels of disease were compared.The correlation between serum factors andinsulin parameters and the influencing factors of T2DM NAFLD disease was analyzed.Results The serum levels of Vaspin [(82.03± 12.46) ng/L vs. (70.81±11.22) ng/L], Visfatin [(39.58±6.90) μg/mL vs. (33.27±5.73) μg/mL], Chemerin [(53.37±8.61) ng/L vs. (45.39± 8.02) ng/L] and HOMA-IR [(2.71±0.67) vs. (1.36±0.54)] in the observation group were higher than those in the control group (P <0.05).The AUC value of Chemerin in the diagnosis of T2DM complicated with NAFLD was the largest, which was 0.758. The serum levels ofVaspin, Visfatin, Chemerin, and HOMA-IR were increased with T2DM and NAFLD progression, ISI showed decreasing trend (P <0.05); serum Vaspin, Visfatin, Chemerin were positively correlated with HOMA-IR, and negatively correlated with ISI (P <0.05),BMI,WHR, serum Vaspin, Visfatin, Chemerin, HOMA -IR and ISI were independent risk factors for the degree of NAFLD in T2DM (P <0.05).Conclu? sion T2DM patients complicated with NAFLD have abnormal expressions of serum Vaspin, Visfatin and Chemerin, and the expressionlevels are closely related to IR, which may indirectly participate in the pathogenesis of T2DM complicated with NAFLD by inducing IR. |
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