糖尿病脂肪肝患者网膜素-1与脂联素、炎症因子关系研究

【摘要】目的研究2型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）患者血浆网膜素-1与脂联素和肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、高敏C反应蛋白（hs-CRP）等炎症因子的关系。方法采用酶联免疫吸附法（ELISA）检测T2DM合并NAFLD组（A组，63例）、T2DM不合并NAFLD组（B组，63例）和正常对照组（C组，70例）的血浆网膜素-1和脂联素水平，同时测定上述3组生化指标及炎症指标（hs-CRP、TNF-α和IL-6），应用相关分析和多元回归分析方法分析血浆网膜素-1与脂联素及炎症指标的关系，应用Logistic回归分析T2DM合并NAFLD的影响因素。结果A组血浆网膜素-1（27.02±2.82）μg/L、脂联素水平（11.98±3.63）mg/L低于B组分别为（31.52±2.81）μg/L（15.85±3.28）mg/L]和C组分别为（35.92±2.80）μg/L、（ 19.88±3.44）mg/L]，且B组低于C组（P＜0.01），A组血浆网膜素-1水平与脂联素、高密度脂蛋白胆固醇（HDL-C）正相关，与TNF-α、IL-6、空腹血（FBG）、胰岛素抵抗指数（HOMAIR）、内脏脂肪面积、腰围、腰臀比（WHR）、游离脂肪酸（FFA）负相关（P＜0.05或P＜0.01）；多元逐步线性回归分析表明脂联素、TNF-α、IL-6是血浆网膜素-1水平的影响因素。Logistic回归分析显示网膜素-1、hs-CRP、内脏脂肪面积及游离脂肪酸（FFA）是T2DM合并NAFLD的独立影响因素（P＜0.01）。结论 T2DM患者合并NAFLD与网膜素-1降低相关，网膜素-1表达可能会受到脂联素及炎症因子的影响。

Association of Plasma Omentin-1Levels with Adiponectin and Inflammatory Cytokines in Diabetic Patients with Fatty Liver

Abstract]ObjectiveTo investigate the relationship of omentin-1with adiponectin and inflammatory cytokines intype 2diabetes (T2DM) patients with nonalcoholic fatty liver disease (NAFLD).Methods The serum levels of omentin-1 and adiponectin were assayed by enzyme-linked immunosorbent assay (ELISA) in patients of T2DM with NAFLD (group A,n=63), T2DM without NAFLD (group B,n=63)and normal control group (group C, n=70). At the same time the biochemical markers and inflammatory marker, such as tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hs-CRP) and interleukin 6(IL-6) were detected in three groups. The correlation analysis and multiple regression analysis were used to detect the association of omentin-1with adiponectin and inflammatory markers. The logistic regression was used to analyze factors influencing NAFLD in patients with T2DM.Results The serum levels of omentin-1 and adiponectin were significantly lower in group A (27.02±2.82) μg/L and (11.98±3.63) mg/L] than those of group B (31.52±2.81) μg/L and (15.85±3.28)mg/L] and group C (35.92±2.80) μg/L and (19.88±3.44) mg/L], and there were significantly lower levels of them in group B than those of group C (P＜0.01). The plasma omentin-1level was positively correlated with adiponectin and high density li-poprotein (HDL-C) in group A. Also the plasma omentin-1level was negatively correlated with TNF-α, IL-6, fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), visceral adipose tissue, waist, waist -to-hip ratio (WHR) and free fatty acid in group A (P＜0.05orP＜0.01). Multiple stepwise regression analysis showed that adiponectin, TNF-αand IL-6were independent factors influencing the level of plasma omentin-1. Logistic regression analysis showed that omentin-1was one of independent factors influencing T2DM combined with NAFLD (P＜0.01).Conclusion The incident of NAFLD in T2DM patients is related to the lower level of omentin-1, which may be influenced by adiponectin and inflammatory factors.