[非酒精性脂肪性肝病对2型糖尿病患者胰岛功能的影响]

[The impact of non-alcoholic fatty liver disease on islet function in type 2 diabetes].

作者信息

Yan Lihui, Wang Shaozhen, Fu Yakun, Wang Xinli, Zheng Xin, Zheng Yadan, Liu Xiuli

出版信息

Zhonghua Nei Ke Za Zhi. 2015 Mar;54(3):197-200.

PMID:26269440

Abstract

OBJECTIVE

To analyze the influence of hepatosteatosis on pancreatic P-cell function in type 2 diabetes mellitus (22DM).

METHODS

A total of 213 subjects with T2DM from Metabolic Disease Hospital, Tianjin Medical University from January 2013 to December 2013 were included in the study. Non-alcoholic fatty liver disease (NAFLD) was diagnosed with abdominal ultrasonography. Patients were divided into two groups: 22DM with NAFLD and 22DM without NAFLD. ALT, AST, gamma-glutamyltransferase, serum lipid, glycosylated hemoglobin A1c ( HbA1c), fructosamine, fasting glucose, insulin and 2 hours plasma glucose, insulin after 75g glucoseload were detected. The insulin resistance and P-cell function were assessed by HOMA-IR and HOMA-P.

RESULTS

Among the 213 22DM subjects, 51% (108 cases) were with NAFLD. The HOMA-IR [4.76(2.83,7.21) vs. 2.79 (1.76, 4.37),P <0.05] and HOMA-P [49.18 (37.78, 85.09) vs. 29.50 (18.09, 45.54), P < 0.05] were significantly higher in 22DM with NAFLD than those in 22DM alone. Within subjects with 22DM and NAFLD,the HOMA-IR [6.28 (2.87, 8.17) vs. 2.95 (2.07, 3.66)P <0. 05] and HOMA-P [59.18 (37.78, 85.09) vs. 30.59 (28.56, 34.49), P < 0.05] levels were higher in subjects with normal liver function than those with abnormal liver function.

CONCLUSIONS

T2DM patients with NAFLD have severer insulin resistance than those without NAFLD. The P-cell function of those patients was compensatory increased, which was decreased in subjects with abnormal liver function.

摘要

目的

分析肝脂肪变性对2型糖尿病（T2DM）患者胰岛β细胞功能的影响。

方法

纳入2013年1月至2013年12月在天津医科大学代谢病医院就诊的213例T2DM患者。采用腹部超声诊断非酒精性脂肪性肝病（NAFLD）。将患者分为两组：合并NAFLD的T2DM组和不合并NAFLD的T2DM组。检测丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转移酶、血脂、糖化血红蛋白A1c（HbA1c）、果糖胺、空腹血糖、胰岛素以及75g葡萄糖负荷后2小时血浆葡萄糖、胰岛素。采用稳态模型评估法（HOMA）-IR和HOMA-β评估胰岛素抵抗和β细胞功能。

结果

213例T2DM患者中，51%（108例）合并NAFLD。合并NAFLD的T2DM组HOMA-IR[4.76（2.83，7.21）比2.79（1.76，4.37），P<0.05]和HOMA-β[49.18（37.78，85.09）比29.50（18.09，45.54），P<0.05]显著高于单纯T2DM组。在合并T2DM和NAFLD的患者中，肝功能正常者的HOMA-IR[6.28（2.87，8.17）比2.95（2.07，3.66），P<0.05]和HOMA-β[59.18（37.78，85.09）比30.59（28.56，34.49），P<0.05]水平高于肝功能异常者。