中老年2型糖尿病血清瘦素水平与超重或肥胖、血糖、胰岛素的关系

目的 研究中老年2型糖尿病（T2DM）肥胖与非肥胖患者血清瘦素与肥胖、血糖、胰岛素抵抗（IR）之间的关系。方法对样本人群进行体检并测定血清瘦素、空腹C肽（FCP）、空腹胰岛素（FINS）及血糖（FPG）等生化指标并对结果进行统计分析。结果 （1）T2DM组无论男女血清瘦素水平均显著高于对照组（P〈0．01），且女性组显著高于男性组（P〈0．01）；（2）T2DM超重或肥胖组血清瘦素水平显著高于非肥胖组且与腹型肥胖密切相关；（3）T2DMIR组血清瘦素水平显著高于胰岛素敏感组（P〈0．01），并与FINS、C肽呈正相关；（4）T2DM肥胖组血清瘦素水平与收缩压（SBP）、舒张压（DBP）、糖化血红蛋白（HbAlc）、甘油三酯（TG）呈正相关。结论 T2DM血清瘦素水平与超重或肥胖、IR、长期的血压、TG及血糖的平均水平关系密切。减肥，改善瘦素抵抗，增加机体对瘦素的敏感性对治疗T2DM可能提供帮助。     

2型糖尿病并发冠心病患者血浆瘦素、超敏C反应蛋白的变化及相关性

目的探讨2型糖尿病(T2DM)并发冠心病(CHD)患者血浆瘦素、超敏C反应蛋白(hs-CRP)的变化及相关性。方法入选符合纳入标准的正常对照组(A组)30例、T2DM组(B组)60例、T2DM合并CHD组(C组)60例,收集研究对象年龄、体重指数(BMI)、腰臀比(WHR)、平均动脉压(MAP)、血脂、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(IRI)、hs-CRP等临床资料。采用双抗体夹心法测定空腹血浆瘦素水平,胶乳比浊法测定血浆hs-CRP水平。结果血浆瘦素、hs-CRP水平在C组较A组及B组均显著升高(P<0.05),但A组和B组间无显著差异(P>0.05)。各组瘦素与hs-CRP进行Pearson相关分析显示,血浆瘦素在A组与hs-CRP未发现相关性,在B组、C组均与hs-CRP呈正相关,相关系数分别为0.359(P=0.005),0.361(P=0.005)。Logistic逐步回归分析显示,瘦素、hs-CRP均是T2DM并发CHD的独立危险因素。结论 T2DM并发CHD患者血浆瘦素、hs-CRP均显著升高,且T2DM无论是否并发CHD,患者血浆瘦素均与hs-CRP呈正相关。瘦素、hs-CRP均是T2DM并发CHD的独立危险因素。     

新诊断2型糖尿病患者合并非酒精性脂肪肝临床分析

目的 探讨新诊断2型糖尿病(T2DM)患者发生非酒精性脂肪性肝病(NAFLD)的危险因素、临床特点.方法 对山西医科大学第一附属医院139例新诊断T2DM的住院患者进行回顾性分析,其中舍并NAFLD者65例,不合并NAFLD者74例.结果 2型糖尿病合并脂肪肝组与无脂肪肝组比较,体重指数(BMI)、三酰甘油(TG),高密度脂蛋白胆固醇(HDL-C)、空腹C肽(FCP)、餐后2 h C肽(2 h CP)、空腹胰岛素(FINS)、丙氨酸转氨酶(ALT)、胰岛素抵抗指数(HOMA-IR)以及24 h尿白蛋白(24 hUALB)有统计学意义(P<0.05或P<0.01);肥胖症、脂代谢紊乱、代谢综合征以及糖尿病肾病的发生率也明显增高(P<0.05或P<0.01);经Logistic回归分析,BMI、FCP和FINS是2型糖尿病并发脂肪肝的危险因素.结论 肥胖、胰岛素抵抗及脂质代谢紊乱是2型糖尿病并发脂肪肝的主要危险因素.     

老年2型糖尿病白细胞介素-6、C反应蛋白、血管内皮生长因子与大血管病变的相关性

目的探讨老年2型糖尿病(T2DM)患者血清白细胞介素(IL)-6、C反应蛋白(CRP)、血管内皮生长因子(VEGF)的变化与大血管病变的相关性。方法 53例T2DM合并大血管病变的患者纳入观察组,45例T2DM未合并大血管病变患者纳入对照组,同期同龄正常体检者30例纳入正常组,比较三组血清IL-6、CRP、VEGF水平。结果与正常组相比,观察组和对照组的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、CRP、IL-6及VEGF水平具有显著性差异(P<0.05);而与对照组比较,观察组仅FPG、2 h PBG、CRP、IL-6及VEGF水平显著升高(P<0.05)。CRP及IL-6水平与TC、LDL、FPG、2 h PBG呈正相关,与HDL、TG无相关性;VEGF水平与TC、LDL、FPG、2 h PBG呈正相关,与HDL呈负相关,与TG无相关性;CRP、IL-6及VEGF间相互呈正相关。结论 T2DM合并大血管病变患者血中CRP、IL-6及VEGF水平明显升高,CRP、IL-6及VEGF可能参与T2DM大血管病变的发生和发展,对大血管病变的预测具有一定的临床意义。     

血清肿瘤坏死因子α、游离脂肪酸以及抵抗素与2型糖尿病患者胰岛素抵抗的关系

目的探讨2型糖尿病(T2DM)患者血清瘦素、TNFα-、游离脂肪酸(FFA)、抵抗素之间及其与胰岛素抵抗(IR)的相关关系。方法选择48例T2DM患者和47例正常人,分别分为肥胖组和非肥胖组。测定各组空腹血清瘦素、TNFα-、FFA、抵抗素水平,同时检测有关项目。结果在对照组和糖尿病组中,血清瘦素、TNF-α、FFA、抵抗素均与HOMA-IR呈正相关(P<0.05~0.01),除了瘦素与抵抗素之间没有显著的相关性外,瘦素、TNF-α、FFA、抵抗素之间均存在正相关。多元线性逐步回归分析,BMI、TG、TNF-α、抵抗素为糖尿病患者IR的独立影响因素。结论BMI、TG、TNF-α和抵抗素是糖尿病患者IR的独立影响因素,可能参与糖尿病的发生。     

2型糖尿病性脂肪肝瘦素等相关因素的分析

目的探讨瘦素(leptin)、谷胱甘肽过氧化物酶(GSH-Px)等因素与2型糖尿病(2DM)性脂肪肝的关系。方法报告了2003-10-2004-06重庆医科大学第二医院检测23例2型糖尿病性脂肪肝,30例2DM患者和30例健康者血清leptin,GSH-Px,血脂及体重指数(BMI),体脂含量(FAT%)水平,作比较相关研究。结果(1)2型糖尿病性脂肪肝甲状腺球蛋白(TG)、BMI、FAT%明显高于其它两组。(2)3组leptin、GSH-Px差异显著,免疫电泳(leptin)与FAT%、年龄相关,GSH-PX与年龄、HDL相关。结论(1)TG、BMI、FAT%是影响2型糖尿病性脂肪肝发生的主要因素。(2)2型糖尿病性脂肪肝和2DM存在“瘦素抵抗”,受肥胖、年龄影响。(3)2DM抗氧化酶降低,与年龄、HDL关系密切。     

T2DM患者血浆内脏脂肪素、瘦素与胰岛素抵抗的相关性研究

目的 探讨2型糖尿病(T2DM)患者血浆内脏脂肪素、瘦素水平与胰岛素抵抗(IR)的相关性.方法 102例T2DM患者和64例正常糖耐量(NGT)对照者,根据BMl分为肥胖组(Ob)和非肥胖(Non-Ob)组,均测定空腹血浆内脏脂肪素、瘦素和相关临床指标,计算胰岛素抵抗指数(HOMA-IR)和腰臀比(WHR).结果 T2DM组与NGT组比较空腹血浆内脏脂肪素和瘦素水平明显升高(t=3.922,P=0.00;t=2.128,P=0.038).相关分析显示T2DM患者空腹血浆内脏脂肪紊与HOMA-IR、WHR、瘦素、HbA<,1> c和TG正相关(r=0.543,P=0.001;r=0.442,P=0.008;r=0.385,P=0.013,r=0.345,P=0.025;r=0.427,P=0.005),瘦素与HOMA-IR、性别、BMI正相关(r=0.578,P<0.01;r=0.547,P<0.01;r=0.607,P<0.01).结论 T2DM患者空腹血浆内脏脂肪素和瘦素水平显著升高,且与IR关系密切.     

2型糖尿病患者空腹血清真胰岛素水平和胰岛素抵抗与血脂的关系

目的　探讨 2型糖尿病 (T2DM )患者空腹血清真胰岛素水平、胰岛素抵抗与血脂的关系。　方法　应用BA ELISA法测定正常糖耐量 (NC)组 96例、T2DM组 132例和T2DM伴原发性高血压 (T2DM EH)组 14 8例的空腹血清真胰岛素 (TI)水平 ,酶法检测血脂 ,计算胰岛素抵抗指数(HOMA IR)、β细胞功能指数 (HOMA β)。 　结果　T2DM组及T2DM EH组的甘油三酯 (TG)、HOMA IR高于NC组 ,高密度脂蛋白胆固醇 (HDL C)和HOMA β低于NC组 ,差异均有显著意义 (P<0 0 5 )。T2DM EH组HOMA IR高于T2DM组 ,差异有显著意义 (P <0 0 5 )。T2DM组及T2DM EH组的TG与TI、HOMA IR呈正相关 (P <0 0 1) ,HDL C与TI、HOMA IR呈负相关 (P <0 0 5 )。　结论　T2DM患者空腹血清TI水平与脂代谢异常相关 ,血清TI水平的升高和 (或 )IR的加重均会引起TG升高和HDL C降低。IR与脂代谢异常及高血压的关系较高TI血症更密切。     

老年糖尿病合并非酒精性脂肪肝与骨密度的关系及相关因素

目的探讨老年糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)与骨密度以及相关因素的关系。方法采取回顾性横断面研究筛选老年T2DM合并NAFLD患者50例为脂肪肝组,另选50例老年T2DM非脂肪肝为对照组。均按照要求测定血压、体重、身高、空腹血糖(FBG)、胰岛素(FINS)、C肽、糖化血红蛋白(Hb A1C)、血脂全套、尿酸、计算体重指数(BMI)、胰岛素敏感指数(ISI),胰岛素抵抗指数(IRI),双能X线骨密度仪测定骨矿物密度(BMD)。结果脂肪肝组体重、BMI、FINS、空腹C肽(FC)、甘油三酯(TG)、低密度脂蛋白(LDL)、尿酸、IRI均较对照组呈显著性增高(P0.05),而ISI、BMD较对照组明显降低(P0.05)。多元回归分析显示:在校正了年龄、BMI、代谢综合征之后,T2DM合并NAFLD与BMD显著相关。结论老年T2DM合并脂肪肝与BMD、脂代谢紊乱及胰岛素抵抗密切相关。     

血清视黄醇结合蛋白4与2型糖尿病合并代谢综合征的相关性

目的探讨血清视黄醇结合蛋白4(RBP4)水平与2型糖尿病(T2DM)及代谢综合征(MS)的相关性及作用机制。方法将108例T2DM患者根据有无合并MS分为T2DM合并MS组(MS组,57例)和T2DM不合并MS组(NMS组,51例),同时按照RBP4水平差距的三分位法将所有患者分为A、B、C 3组,另选择健康体检者37例为对照组。比较各组的血脂、空腹血糖(FPG)等生化指标和RBP4的差异。结果与对照组比较,NMS组和MS组的收缩压、舒张压、TG、LDL、FPG、RBP4显著升高,HDL降低(P<0.05);与A组和B组比较,C组的TG、腰围和大血管并发症明显升高(P<0.05,P<0.01);Pearson分析显示,RBP4与体质量指数(BMI)、腰围、收缩压、舒张压、FPG、TG呈正相关,与HDL呈负相关。logistic分析显示,RBP4、BMI、腰围、FPG、TG、TC是MS的危险因素(P<0.05)。结论 RBP4在T2DM的发生中起重要作用,并促进MS的发生。     

2型糖尿病合并脂肪肝危险因素临床分析

目的:探讨2型糖尿病合并脂肪肝的患病率及相关因素．方法:对179例糖尿病患者进行临床、生化、胰岛素及肝脏彩超检查．结果:2型糖尿病合并脂肪肝的患病率为47．5％,该组的体重指数、空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)及甘油三酯高于于非脂肪肝组,2 h胰岛素无差异．以不同的体重指数分层,随着体重指数的增加,甘油三酯及HOMA-IR亦升高,而脂肪肝的患病率亦呈增加趋势．Logistic回归分析显示, HOMA-IR对于脂肪肝患病率的增加有显著意义(OR=1．582,P=0．023)．结论:影响2型糖尿病合并脂肪肝的因素很多,胰岛素抵抗可能为主要影响因素．体重指数可能通过高甘油三酯及胰岛素抵抗影响脂肪肝的形成．     

新诊断1型糖尿病患者血清瘦素质量浓度及短期胰岛素治疗对其影响

目的　观察新诊断 1型糖尿病患者血清瘦素质量浓度变化及胰岛素治疗对瘦素质量浓度的影响 ,进而探讨胰岛素和瘦素间的相互作用。方法　 1999- 0 7～ 2 0 0 0 - 0 7哈尔滨医科大学附属第二医院门诊和病房 2 9例新诊断的 1型糖尿病患者和 2 0名正常对照者彻夜空腹 14h后 ,第 2天早晨 8时采血检测血糖、HbA1c、甘油三酯、胆固醇、胰岛素、C肽及瘦素 ,然后对 1型糖尿病患者行皮下胰岛素注射治疗 ,2周后检测血糖、胰岛素、C肽和瘦素。结果　新诊断的 1型糖尿病患者血清瘦素质量浓度明显低于对照者 (P <0 0 5 ) ,胰岛素治疗 2周后 ,瘦素质量浓度无明显变化 (P >0 0 5 ) ;相关分析显示 ,对照组空腹血清瘦素质量浓度与性别、体重指数 (BMI)和胰岛素浓度具有相关性 ,新诊断 1型糖尿病组血清瘦素质量浓度仅与性别、胰岛素浓度具有相关性。结论　新诊断 1型糖尿病患者在胰岛素治疗前血清瘦素质量浓度低于对照者。短期胰岛素皮下注射治疗对血清瘦素质量浓度无明显影响。     

Association of nonalcoholic fatty liver disease with abnormal aminotransferase and postprandial hyperglycemia

GOALS: This study was conducted to explore the association between nonalcoholic fatty liver disease and glucose metabolism as well as insulin resistance using the homeostasis model assessment method (HOMA). STUDY: From July 2003 to June 2004, 23 patients with ultrasound-proved fatty liver and either normal (10 patients) or abnormal (13 patients) serum aminotransferase levels were enrolled. Blood tests included a routine biochemistry, a 75-g glucose oral glucose tolerance test (OGTT) with blood sampled at 30-minute intervals during a 120-minute period. Fasting and 120-minute serum leptin, insulin, and C-peptide concentrations were also measured. RESULTS: Using the Mann-Whitney U test, significant differences were found in gamma glutamyl transpeptidase (28.6+/-7.9 vs. 65.1+/-65.9 U/L, P=0.008), fasting insulin (FI) (13.11+/-7.53 vs. 31.76+/-42.95 muU/mL, P=0.02), fasting C-peptide (3.82+/-3.00 vs. 2.17+/-0.43 ng/mL, P=0.01), fasting leptin (10.34+/-4.05 vs. 24.27+/-24.97 ng/mL, P=0.01), HOMA-IR (3.34+/-1.06 vs. 8.81+/-13.18, P=0.02), and HOMA beta-cell function (120.32+/-52.50 vs. 242.20+/-247.29, P=0.02) between normal and abnormal ALT/AST function groups. From the 75-g OGTT, no significant difference of plasma glucose was noted at 0, 30, 60, and 90 minutes but significant change was noted in 120-minute plasma glucose (99.3+/-21.5 vs. 131.4+/-27.3 mg/dL, P=0.004) of 2 groups. CONCLUSIONS: In conclusion, patients with fatty liver proved by ultrasound sonography might be at high risk of developing type 2 diabetes, especially when they had elevated liver enzymes. OGTT is warranted for the early diagnosis of these high risk patients.     

Non-alcoholic fatty liver disease is independently associated with an increased prevalence of chronic kidney disease and retinopathy in type 1 diabetic patients

Aims/hypothesis  

Non-alcoholic fatty liver disease (NAFLD) is associated with an increased prevalence of chronic kidney disease (CKD) and retinopathy in patients with type 2 diabetes. Information on this issue is lacking for type 1 diabetes. We evaluated whether NAFLD is associated with increased prevalence of retinopathy and CKD in type 1 diabetic patients.     

Prevalence and associated factors of non‐alcoholic fatty liver disease in patients with type‐2 diabetes mellitus

Background/Aims: Diabetic patients have an increased prevalence and severity of non‐alcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence and the factors associated with the presence of ultrasonographic NAFLD in type‐2 diabetic individuals. Methods: In a cross‐sectional design study, 180 type‐2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. Statistical analysis included bivariate tests, analysis of variance (anova , for increasing severity of steatosis) and multivariate logistic regression. Results: The prevalence of ultrasonographic NAFLD was 69.4% [95% confidence interval (CI): 58.3–82.7%]. Patients with NAFLD were more obese, had a higher waist circumference and serum triglyceride and alanine aminotransferase (ALT) levels than those without steatosis. Neither diabetic degenerative complication, nor glycaemic control was associated with liver steatosis. On multivariate analysis, a high serum triglycerides level [>2.82 mmol/L, odds ratio (OR): 3.7–4.1, 95% CI: 1.2–13.3] and a high‐normal ALT level (≥40 U/L, OR: 2.5–2.7, 95% CI: 1.2–5.9) were independently associated with hepatic steatosis, together with either the presence of obesity (OR: 7.1, 95% CI: 3.0–17.0) or of increased waist circumference (OR: 4.8, 95% CI: 1.9–12.2). Conclusions: Type‐2 diabetic patients have a high prevalence of ultrasonographic NAFLD and its presence is associated with obesity, mainly abdominal, hypertriglyceridaemia and high‐normal ALT levels. Non‐alcoholic fatty liver disease in diabetic patients may develop and progress independent of the diabetes progression itself.     

Association between serum C-peptide levels and chronic microvascular complications in Korean type 2 diabetic patients

This study evaluated the association between serum C-peptide levels and chronic vascular complications in Korean patients with type 2 diabetes. Data for 1,410 patients with type 2 diabetes were evaluated cross-sectionally. Fasting and postprandial 2-hour serum C-peptide levels were analyzed with respect to diabetic micro- and macrovascular complications. In the group of patients with lower fasting serum C-peptide quartile, the prevalences of diabetic retinopathy and neuropathy were significantly higher (P = 0.035, P < 0.001, respectively). In the group of patients with lower delta C-peptide (postprandial − fasting C-peptide) quartile, the prevalences of diabetic retinopathy, nephropathy, and neuropathy were significantly higher (P < 0.001 for all). Low delta C-peptide quartile was also associated with increased severity of retinopathy and nephropathy. The age- and sex-adjusted odds ratios (ORs) for retinopathy, neuropathy, and nephropathy in the lowest versus the highest delta C-peptide quartile were 6.45 (95% confidence interval 3.41–12.22), 3.01 (2.16–4.19), and 2.65 (1.71–4.12), respectively. After further adjustment for the duration of diabetes, type of antidiabetic therapy, mean hemoglobin A1c, body mass index, and blood pressure, the ORs were reduced to 2.83 (1.32–6.08), 1.68 (1.12–2.53), and 1.61 (1.05–2.47), respectively, but remained significant. No significant difference was observed in the prevalence of macrovascular complications with respect to fasting or delta C-peptide quartiles. These results suggest that low C-peptide level is associated with diabetic microvascular, but not macrovascular complications in patients with type 2 diabetes mellitus.     

Metabolic evolution of type 2 diabetes: a 10-year follow-up from the time of diagnosis

Abstract. Objectives. To investigate fasting and post-load plasma glucose, insulin and C-peptide levels during oral glucose tolerance tests in patients with type 2 diabetes and in control subjects, and the metabolic evolution of the diabetes. Design, setting and subjects. A 10-year prospective study consisting of a representative group of 133 (70 men, 63 women) newly diagnosed type 2 diabetic patients diagnosed at health centres between 1979 and 1981 and 144 (62 men, 82 women) nondiabetic control subjects recruited from the population register. At baseline, diabetic subjects were treated with diet only. The subjects were studied at baseline and after 5 and 10 years. Main outcome measures. The changes in plasma glucose, insulin and C-peptide levels in diabetic and control subjects at baseline and after 5 and 10 years follow-up. Factors associated with the decline in insulin and C-peptide levels in diabetic patients (e.g. metabolic control, islet cell antibodies). Results. A slight increase in glucose levels was seen during the follow-up in both diabetic with diet and/or oral drug treated patients, but post-glucose insulin (and C-peptide and 5- and 10-year examination) levels declined in diabetic patients; this was opposite to the controls, in whom the levels tended to increase. The decline in insulin levels (area under the curve) during the follow-up was greatest in those diabetic patients with poor metabolic control during the follow-up. The cumulative incidence of requirement for insulin based on various cut-off levels for post-glucagon C-peptide nearly doubled between the 5- and 10-year examinations. Islet cell antibodies were predictive of insulin deficiency. Conclusions. Type 2 diabetes was characterized by progressive impairment of insulin response to glucose and this decline was associated with poor metabolic control of diabetes.     

2型糖尿病患者非酒精性脂肪肝与微血管病变关系的研究

目的探讨2型糖尿病(T2DM)患者中非酒精性脂肪肝(NAFLD)与慢性肾脏疾病(CKD)及糖尿病视网膜病变(DR)的关系。方法收集2008年5月至2009年7月上海交通大学附属第一人民医院内分泌代谢科448例T2DM患者的临床资料,按是否合并NAFLD分组,比较两组间CKD和DR的发生率及其与NAFLD的联系。结果(1)448例T2DM患者中NAFLD合并率为59.4%。(2)与无NAFLD组相比,NAFLD组尿白蛋白/肌酐比值(UACR)及CKD和DR的发病率明显升高(P0.01)。(3)Logistic回归分析显示,NAFLD是T2DM患者发生CKD和DR的独立危险因素(OR=1.9,P0.05;OR=2.8,P0.01)。结论T2DM患者中NAFLD与CKD和DR密切相关,提示通过早期诊断和干预NAFLD可预防微血管并发症。     

The combination of carotid and lower extremity ultrasonography increases the detection of atherosclerosis in type 2 diabetes patients

ObjectiveTo evaluate the prevalence of atherosclerosis detected by both carotid and lower extremity ultrasonography in hospitalized Chinese type 2 diabetic patients and to examine whether plaque formation in the carotid arteries could be an indicator of generalized atherosclerosis in type 2 diabetes mellitus.MethodsTotally, 709 hospitalized Chinese type 2 diabetic patients (men 357, women 352) aged from 18 to 88 years were included. Both carotid and lower extremity atherosclerosis were assessed by Doppler ultrasound. Atherosclerosis was defined as the presence of either the carotid or lower extremity plaque in any of the above-mentioned arteries segments. The prevalence of atherosclerosis was calculated, and the risk factors associated with atherosclerosis were evaluated using binary logistic regression.ResultsThe prevalence of atherosclerosis was 81.23% in male and 77.56% in female type 2 diabetic patients, respectively. There was no significant difference in the prevalence of atherosclerosis in patients between the sexes. The prevalence of atherosclerosis was significantly higher in the lower extremity arteries than in the carotid arteries (73.91% and 44.43%, respectively, P<.001). Atherosclerosis was significantly associated with smoking, age, duration of diabetes, systolic blood pressure, total number of white blood cells, and mean carotid and femoral intima-media thickness (IMT).ConclusionsThe prevalence of atherosclerosis was very high in Chinese inpatients with type 2 diabetes. Carotid atherosclerosis could not be an indicator of generalized atherosclerosis in type 2 diabetes. The combination of carotid and lower extremity ultrasound examination can significantly improve the detection of atherosclerosis in type 2 diabetes.     

老年2型糖尿病合并非酒精性脂肪性肝病患者Vaspin水平的变化

目的研究老年T2DM合并非酒精性脂肪性肝病（NAFLD）患者血清Vaspin水平的变化及其临床意义。方法测定老年T2DM合并NAFLD患者44例（T2DM＋NAFLD组）,老年T2DM不合并NAFLD患者40例（T2DM组）,老年糖耐量正常的NAFLD患者40例（NAFLD组）与老年正常对照41名（NC组）的Vaspin水平。结果T2DM＋NAFLD组、T2DM组、NAFLD组血清Vaspin水平均明显高于NC组（1．46±0．43、1．03±0．27、0．76±0．28vs0．36±0．13）ng／ml,差异有统计学意义（P〈0．01或P％0．05）。多元逐步回归分析显示Fins、内脏脂肪厚度（VFT）、HbA1c是Vaspin水平的独立影响因素,Vaspin、VFT和TG是老年T2DM合并NAFLD的危险因素。结论血清Vaspin水平的变化可能在老年T2DM合并NAFLD的发生发展中起一定作用。