2型糖尿病合并脂肪肝患者血清同型半胱氨酸水平的临床研究

目的:探讨空腹血清同型半胱氨酸(tHCY),在新诊断的2型糖尿病(T2DM)合并非酒精性脂肪性肝病患者中的临床意义。方法:将79例新诊断的2型糖尿病患者分为合并非酒精性脂肪性肝病组39例,不合并非酒精性脂肪性肝病组40例,分别测定体质量指数(BMI)、腰臀比(W/H)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、空腹血糖(FPG)、空腹胰岛素(FINS)、血清同型半胱氨酸、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI)。结果:合并非酒精性脂肪性肝病组的血清同型半胱氨酸以及BMI、W/H、ALT、AST、FINS、TG及HOMA-IR较不合并非酒精性脂肪性肝病组显著增高(P<0.01),合并非酒精性脂肪性肝病组的年龄、ISI显著降低(P<0.01)。新诊断的T2DM是否合并非酒精性脂肪性肝病与年龄、BMI、FINS及tHCY有相关性(P<0.05)。tHCY与BMI(r=0.281,P<0.05),FINS(r=0.268,P<0.05),W/H(r=0.376,P<0.01)呈正相关。结论:BMI、空腹胰岛素及血清同型半胱氨酸水平是新诊断的T2DM合并非酒精性脂肪性肝病的危险因素,并且BMI、腰臀比、空腹胰岛素水平与血清同型半胱氨酸水平具有相关性。

Clinical study on serum homocysteine of type 2 diabetics with fatty liver disease

Objective： To investigate the clinical significance of serum homocysteine （HCY） of newly diagnosed type 2 diabetics（T2DM） with nonalcohol fatty liver disease（ NAFLD）. Method：79 patients with T2DM were divided into two groups, 39 diabetics with NAFLD and 40 diabetics without NAFLD. Body mass index（BMI）, fasting blood glucose （FPG）, insulin （FINS）, homocysteine （HCY）, glycosylated hemoglobin （HbAlc）, cholesterol total （TC）, triglyceride （ TG ）, high density lipopretein （ HDL- C ）, low density lipoprotein （ LDL- C ） were measured. Insulin resistance index（HOMA-IR） and insulin sensitivity index （ISI） were calculated. Result： The level of tHCY and BMI, W/H,ACT, AST, FINS, TG, HOMA-IR in the diabetics with NAFLD was significantly higher than that in type 2 diabetics without NAFLD（ P 〈 0.01 ）. The levels of age and ISI were significantly lower than those T2DM without NAFLD（ P 〈 0.01 ）. The level of tHCY was positive correlated with BMI（ r = 0. 281, P 〈 0.05 ）, FINS（ r = 0. 268, P 〈0.05）, W/H（r = 0.376, P 〈 0.01） respectively. Conclusion： The levels of BMI,FINS and tHCY are risk factors in newly diagnosed type 2 diabetics with NAFLD. The levels of BMI,W/H and FINS are correlated with tHCY.