| 孟令华,位庚,常湛,等.2型糖尿病病人外周血羧化不全骨钙素水平与合并非酒精性脂肪性肝病的关系分析[J].安徽医药,2024,28(10):2026-2030. |
| 2型糖尿病病人外周血羧化不全骨钙素水平与合并非酒精性脂肪性肝病的关系分析 |
| Analysis of the relationship between peripheral blood undercarboxylated osteocalcin level and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2024.10.024 |
| 中文关键词: 糖尿病， 2型 非酒精性脂肪性肝病 羧化不全骨钙素 影响因素 受试者操作特征曲线 |
| 英文关键词: Diabetes mellitus, type 2 Non-alcoholic fatty liver disease Carboxylated incomplete osteocalcin Influencing factor Receiver operating characteristic curve |
| 基金项目:河北省医学科学研究重点课题计划项目( 20201351) |
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| 中文摘要: |
| 目的检测 2型糖尿病( T2DM)病人羧化不全骨钙素( ucOC)浓度，并分析其与合并非酒精性脂肪性肝病( NAFLD)的关系。方法选取石家庄市第二医院 2020年 6月至 2022年 6月收治的 234例 T2DM病人设为疾病组，根据病人是否合并 NAFLD分为 NAFLD组( 107例)和非 NAFLD组( 127例)同期选取 231例健康体检者为对照组，采用酶联免疫吸附测定检测受试者外周血 ucOC浓度。比较 NAFLD组和非 NAFLD组病，人的临床资料，采用多因素 logistic回归分析法分析 T2DM病人合并 NAFLD的影响因素，并绘制受试者操作特征曲线( ROC曲线)评价外周血 ucOC浓度对 T2DM合并 NAFLD的诊断价值。结果疾病组外周血 ucOC浓度［(1.10±0.42)μg/L］低于对照组［( 1.53±0.68)μg/L］(P<0.05)； NAFLD组 ucOC［( 0.98±0.14)μg/L］低于非 NAFLD组［( 1.20±0.21)μg/L］(P<0.05)。 NAFLD组身体质量指数( BMI)、腰臀比以及空腹胰岛素( FINS)、糖化血红蛋白(HbA1c)、舒张压、总胆固醇( TC)、三酰甘油( TG)、低密度脂蛋白( LDL-C)、尿酸、胰岛素抵抗指数( HOMA-IR)均高于非 NAFLD组( P<0.05)高密度脂蛋白( HDL-C)低于非 NAFLD组( P<0.05)。多因素结果显示， HbA1c、TG、尿酸及 HOMA-IR升高均是 T2DM病人合并，NAFLD的危险因素( P<0.05)，外周血 ucOC浓度升高是其保护因素( P<0.05)。外周血 ucOC浓度诊断 T2DM病人合并 NAFLD的最佳截断值、灵敏度、特异度、曲线下面积分别为 1.05 μg/L、83.18%、80.31%、0.84。结论 T2DM病人外周血 ucOC浓度降低，且合并 NAFLD病人外周血 ucOC浓度低于未合并病人。 ucOC浓度与 HbA1c、TG、尿酸、 HOMA-IR均是 T2DM病人合并 NAFLD的影响因素，监测 T2DM病人 ucOC浓度变化有助于临床诊断 NAFLD的发生。 |
| 英文摘要: |
| Objective To detect the concentration of uncarboxylated osteocalcin (ucOC) in patients with type 2 diabetes mellitus(T2DM), and to analyze its relationship with nonalcoholic fatty liver disease (NAFLD).Methods A total of 234 patients with T2DM admitted to Shijiazhuang Second Hospital from June 2020 to June 2022 were selected as the disease group, and they were further assignedinto NAFLD group (107 cases) and non-NAFLD group (127 cases) according to whether the patients were complicated with NAFLD. Atthe same time, 231 healthy subjects were selected as the control group. The concentration of ucOC in the peripheral blood of subjects wasdetected by enzyme-linked immunosorbent assay. The clinical data of patients in NAFLD group and non-NAFLD group were compared.Multivariate Logistic regression analysis was used to analyze the influencing factors of NAFLD in T2DM patients, and receiver operatingcharacteristic (ROC) curve was drawn to evaluate the diagnostic value of ucOC concentration in peripheral blood for T2DM with NAFLD.Results The concentration of ucOC in peripheral blood of the disease group [(1.10±0.42) μg/L] was lower than that of the control group[(1.53±0.68) μg/L] (P < 0.05), and the ucOC in NAFLD group [ (0.98±0.14) μg/L ] was lower than that in non-NAFLD group [(1.20±0.21) μg/L] (P < 0.05). The levels of body mass index (BMI), waist-to-hip ratio, glycosylated hemoglobin (HbA1c), fasting insulin (FINS), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL-C), serum uric acid (UA) and insulin resistance index (HOMA-IR) in NAFLD group were higher than those in non-NAFLD group (P < 0.05), while the levels of high density lipoprotein (HDL-C) was lower than that in non-NAFLD group (P < 0.05). Multivariate results showed that elevated HbA1c, TG, UA level, and HOMA-IR were risk factors for NAFLD in T2DM patients (P < 0.05), and the increase of ucOC concentration in peripheral blood was a protective factor (P < 0.05). The optimal cut-off point, sensitivity, specificity and area under the curve of peripheral blood ucOC concentration in the diagnosis T2DM patients with NAFLD were 1.05 μg/L, 83.18 %, 80.31 % and 0.84, respectively.Conclusions The con centration of ucOC in peripheral blood of patients with T2DM decreased, and the concentration of ucOC in peripheral blood of patientswith NAFLD is lower than that of patients without NAFLD. The levels of ucOC, HbA1c, TG, UA and HOMA-IR are the influencing factorsof NAFLD in T2DM patients. Monitoring the changes of ucOC in T2DM patients is helpful to diagnose NAFLD. |
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