2型糖尿病合并非酒精性脂肪肝患者颈动脉内膜中层厚度与脂联素的相关性

目的探讨脂联素与2型糖尿病合并非酒精性脂肪肝患者颈动脉内膜中层厚度(IMT)的关系。方法选择85例2型糖尿病患者,按是否合并非酒精性脂肪肝分为2型糖尿病合并非酒精性脂肪肝组(合并组,41例)和无非酒精性脂肪肝的糖尿病组(对照组,44例)。检测两组患者空腹血糖(FPG)、空腹胰岛素(FINS)、脂联素、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG),测定IMT,同时计算体质指数(BMI)、胰岛素抵抗指数(HOMA-IR),并进行相关分析。结果合并组患者的FPG、BMI、TG、TC、LDL-C、FINS及HOMA-IR均高于对照组,差异均有统计学意义(P<0.05,P<0.01)。合并组患者左、右两侧颈动脉内膜中层厚度高于对照组,而脂联素水平较对照组低,差异均有统计学意义(P<0.01,P<0.05)。Pearson相关分析结果表明,IMT与BM(Ir=0.435,P<0.01)、FPG(r=0.402,P<0.01)、FINS(r=0.410,P<0.01)、HOMA-IR(r=0.596,P<0.01)、TG(r=0.416,P<0.01)、LDL-C(r=0.458,P<0.01)呈正相关,与脂联素(r=-0.306,P<0.05)、HDL-C(r=-0.347,P<0.05)呈负相关。结论 2型糖尿病合并非酒精性脂肪肝患者较无非酒精性脂肪肝的糖尿病患者存在更明显的代谢紊乱和胰岛素抵抗,与动脉粥样硬化的发生发展有关。

Relationship between the Carotid Intima-media Thickness and Adiponectin among Type 2 Diabetes Mellitus Patients Complicated with Non-alcoholic Fatty Liver Disease

Objective To investigate the relationship between the intima-media thickness(IMT)and adiponectin among type 2 diabetes mellitus(T2DM)patients complicated with non-alcoholic fatty liver disease.Methods 85 cases with T2DM were divided into two groups:DM+NAFLD group(with non-alcoholic fatty liver disease,n=41)and DM group(without NAFLD,n=44).The serum levels of fasting plasma glucose(FPG),fasting insulin(FINS),adiponectin,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG)and intima-media thickness(IMT)were detected.Body mass index(BMI)and homeostasis model assessment of insulin resistance(HOMA-IR)were calculated.A linear correlation analysis was used.Results The levels of BMI,FPG,TG,TC,LDL-C were higher in DM+NAFLD group than those in DM group(P<0.05),and so were the levels of FINS and HOMA-IR(P<0.05 or P<0.01)and the levels of IMT-L and IMT-R(P<0.01),but the levels of adiponectin was lower in DM+NAFLD group than in DM group(P<0.05).IMT was positively correlated with BMI,FPG,FINS,HOMA-IR,TG and LDL-C(P<0.05 or P<0.01),but negatively correlated with adiponectin and HDL-C(P<0.05).Conclusion Type 2 diabetes individuals with NAFLD are significantly characterized by both metabolic disorder and insulin resistant,which is relate to the development and progression of atherosclerotic disease.