| 孙涛,张婷婷,张示渊.CYFRA21-1在非酒精性脂肪性肝病并发 2型糖尿病病人中的水平及其与胰岛素抵抗的关系[J].安徽医药,2026,30(3):532-536. |
| CYFRA21-1在非酒精性脂肪性肝病并发 2型糖尿病病人中的水平及其与胰岛素抵抗的关系 |
| Levels of CYFRA21-1 in patients with non-alcoholic fatty liver disease complicated by type 2 diabetes and its relationship with insulin resistance |
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| DOI：10.3969/j.issn.1009-6469.2026.03.020 |
| 中文关键词: 非酒精性脂肪性肝病 2型糖尿病 细胞角蛋白 19片段 胰岛素抵抗 相关性 |
| 英文关键词: Non alcoholic fatty liver disease Type 2 diabetes mellitus Cytokeratin 19 fragment Insulin resistance Correlation |
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| 中文摘要: |
| 目的探讨非酒精性脂肪性肝病( NAFLD)并发 2型糖尿病( T2DM)病人中细胞角蛋白 19片段( CYFRA21-1)的水平及其与胰岛素抵抗( IR)的相关性。方法选取第八师石河子市总医院 2020年 6月至 2023年 6月收治的 291例 NAFLD病人作为研究对象，根据 NAFLD病人是否并发 T2DM将其分为 NAFLD并发 T2DM病人( T2DM组， 133例)和 NAFLD未并发 T2DM病人(非 T2DM组， 158例)。收集两组病人年龄、性别等一般临床资料，并检测病人 C反应蛋白(CRP)、空腹血糖( FPG)、空腹胰岛素(FINS)、丙氨酸氨基转移酶( ALT)、总胆固醇( TC)、甘油三酯( TG)、天冬氨酸氨基转移酶( AST)、 γ-谷氨酰转移酶( GGT)、高密度脂蛋白胆固醇( HDL-C)、低密度脂蛋白胆固醇( LDL-C)等生化指标及 CYFRA21-1水平，并计算胰岛素抵抗指数( HOMA-IR)以及胰岛素敏感指数(ISI)。采用 logistic回归分析探究 NAFLD病人并发 T2DM的影响因素， Pearson相关性分析检验 NAFLD并发 T2DM病人 CYFRA21-1与 HOMA-IR、ISI的相关性，受试者操作特征曲线( ROC曲线)分析 CYFRA21-1、HOMA-IR和 ISI对 NAFLD并发 T2DM的诊断效能。结果 T2DM组病人 CRP、FPG、FINS、GGT水平显著高于非 T2DM组( P<0.05)HDL-C水平显著低于非 T2DM组(P<0.05)；与非 T2DM组相比， T2DM组病人 CYFRA21-1水平显著升高［(4.52±1.35)μg/L比( 2.33，±0.96)μg/L， P<0.05］HOMA-IR水平显著升高( P<0.05)ISI水平显著降低( P<0.05)； logistic回归结果显示， CYFRA21-1、HOMA-IR、CRP、 FPG、FINS、G，GT水平均是导致 NAFLD病人并发，T2DM的独立危险因素( P<0.05)，ISI、HDL-C均是 NAFLD病人并发 T2DM的独立保护因素( P<0.05)； Pearson相关性分析显示 NAFLD并发 T2DM病人血清 CYFRA21-1与 HOMA-IR水平呈正相关( r=0.69，P<0.001)，与 ISI水平呈负相关( r=.0.60，P<0.001)。 CYFRA21-1、HOMA-IR和 ISI以及三者联合诊断 NAFLD并发 T2DM的 AUC及其 95%CI分别为 0.89(0.85，0.83)、 0.68(0.63，0.74)、 0.74(0.68，0.79)和 0.92(0.89，0.95)。三项联合诊断结果优于 CYFRA21-1、 HOMA-IR和 ISI单独分析(均 P<0.05)。结论 CYFRA21-1在 NAFLD并发 T2DM病人中的水平显著升高，且 CYFRA21-1与 IR密切相关，其与 HOMA-IR呈正相关，与 ISI呈负相关。 |
| 英文摘要: |
| Objective To investigate the level of cytokeratin 19 fragment (CYFRA21-1) and its correlation with insulin resistance (IR) in patients with non-alcoholic fatty liver disease (NAFLD) complicated by type 2 diabetes mellitus (T2DM).Methods A total of 291 NAFLD patients admitted to Eighth Division Shihezi General Hospital from June 2020 to June 2023 were regarded as the studysubjects, who were assigned into NAFLD patients with T2DM (T2DM group, n=133) or NAFLD patients without T2DM (non-T2DM group, n=158) based on whether they were complicated with T2DM. General clinical data such as age and gender of both groups werecollected, and measurement was performed of biochemical indicators including C-reactive protein (CRP), fasting plasma glucose(FPG), fasting insulin (FINS), alanine aminotransferase (ALT), total cholesterol (TC), triglycerides (TG), aspartate aminotransferase(AST), γ -glutamyltransferase (GGT), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), and CYFRA21-1 levels. The insulin resistance index (HOMA-IR) and insulin sensitivity index (ISI) were calculated. The factors influ.encing concurrent T2DM were explored using logistic regression; Pearson correlation analysis was used to investigate the relationship ofCYFRA21-1 with HOMA-IR and ISI in NAFLD patients with T2DM; Receiver operating characteristic curve (ROC curve) analysis wasmade to evaluate the diagnostic performance of CYFRA21-1, HOMA-IR, and ISI for detecting T2DM in NAFLD patients.Results The levels of CRP, FPG, FINS, and GGT in the T2DM group were significantly higher than those in the non-T2DM group (P<0.05), while the level of HDL-C was significantly lower than that in the non-T2DM group (P<0.05). Compared with the non-T2DM group, patients in the T2DM group had significantly elevated CYFRA21-1 [(4.52±1.35) μg/L vs. (2.33±0.96) μg/L, P<0.05], significantly increased HOMA-IR (P<0.05), and significantly decreased ISI (P<0.05). Logistic regression results showed that CYFRA21-1, HOMA-IR, CRP, FPG, FINS, and GGT were all independent risk factors for T2DM in NAFLD patients (P<0.05), while ISI and HDL-C were independent protective fac. tors (P<0.05). Pearson correlation analysis results showed that there was a positive correlation between serum CYFRA21-1 and HOMA-IR levels in patients with NAFLD complicated by T2DM (r=0.69, P<0.001), and there was a negative correlation between CYFRA21-1 and ISI levels (r=.0.60, P<0.001). The AUC and 95%CI of CYFRA21-1, HOMA-IR, and ISI alone and the combination of the three for thediagnosis of NAFLD complicated by T2DM were 0.89 (0.85,0.83), 0.68 (0.63, 0.74), 0.74 (0.68, 0.79), and 0.92 (0.89, 0.95), respective.ly, and the combined diagnostic outcome of the three indicators was superior to those of CYFRA21-1, HOMA-IR, and ISI when ana. lyzed alone (all P<0.05). Conclusion CYFRA21-1 was significantly elevated in NAFLD patients with concomitant T2DM. Further. more, CYFRA21-1 was closely associated with IR, showing a positive correlation with HOMA-IR and a negative correlation with ISI. |
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