Zhang Zhengjun, Wang Jijun, Wang Hongmei
Department of Endocrinology, The Affiliated Hospital of Jining Medical University, Jining, Shandong 272000, P.R. China.
Department of Internal Medicine, Jining Municipal Government Hospital, Jining, Shandong 272100, P.R. China.
Exp Ther Med. 2018 Mar;15(3):2936-2940. doi: 10.3892/etm.2018.5753. Epub 2018 Jan 16.
Non-alcoholic fatty liver disease (NAFLD) is a form of clinical syndrome characterized by the fatty degeneration in liver histology and should be further investigated. The aim of the study was to investigate the effects of blood glucose, serum chemerin and insulin resistance on non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus to provide a basis for the prevention and treatment thereof. In total, 300 patients with type 2 diabetes mellitus treated and admitted into the Endocrinology Department of our hospital from June 2015 to June 2017 were enrolled and divided into the simple type 2 diabetes mellitus (group A) and concurrent NAFLD (group B) groups. The sex, age, body mass index (BMI), blood pressure, blood biochemical indexes and chemerin level were compared between the two groups. The patients in group B were further divided into the mild fatty liver (group B1), moderate fatty liver (group B2) and severe fatty liver (group B3) groups. The sex, age, BMI blood pressure, blood biochemical indexes and chemerin level were also compared among the three groups. Finally, the risk factors of type 2 diabetes mellitus complicated by NAFLD were analyzed via logistic regression. The BMI, fasting plasma glucose (FPG), 2 h post-prandial plasma glucose (2hPG), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), alanine aminotransferase (ALT), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR) and HOMA-β indexes and serum chemerin level in group B were significantly higher than those in group A (P<0.05 or P<0.01). Notably, the aggravation of NAFLD, the aforementioned indexes were obviously increased (P<0.05 or P<0.01). The regression analysis revealed that BMI, FPG, TC, LDL-c, FINS, HOMA-IR and chemerin were risk factors of concurrent NAFLD. Thus, type 2 diabetes mellitus complicated by NAFLD is closely associated with severe glucose-lipid metabolism disorder and insulin resistance, and BMI, FPG, TC, LDL-c, FINS, HOMA-IR and chemerin constitute risk factors of concurrent NAFLD.
非酒精性脂肪性肝病（NAFLD）是一种以肝脏组织学脂肪变性为特征的临床综合征形式，应进一步研究。本研究旨在探讨血糖、血清趋化素和胰岛素抵抗对2型糖尿病患者非酒精性脂肪性肝病（NAFLD）的影响，为其防治提供依据。选取2015年6月至2017年6月在我院内分泌科治疗并收治的300例2型糖尿病患者，分为单纯2型糖尿病组（A组）和合并NAFLD组（B组）。比较两组患者的性别、年龄、体重指数（BMI）、血压、血液生化指标及趋化素水平。B组患者进一步分为轻度脂肪肝组（B1组）、中度脂肪肝组（B2组）和重度脂肪肝组（B3组）。比较三组患者的性别、年龄、BMI、血压、血液生化指标及趋化素水平。最后，通过logistic回归分析2型糖尿病合并NAFLD的危险因素。B组患者的BMI、空腹血糖（FPG）、餐后2小时血糖（2hPG）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）、丙氨酸氨基转移酶（ALT）、空腹胰岛素（FINS）、胰岛素抵抗稳态模型评估（HOMA-IR）和HOMA-β指数及血清趋化素水平均显著高于A组（P<0.05或P<0.01）。值得注意的是，随着NAFLD病情加重，上述指标明显升高（P<0.05或P<0.01）。回归分析显示，BMI、FPG、TC、LDL-c、FINS、HOMA-IR和趋化素是合并NAFLD的危险因素。因此，2型糖尿病合并NAFLD与严重的糖脂代谢紊乱和胰岛素抵抗密切相关，BMI、FPG、TC、LDL-c、FINS、HOMA-IR和趋化素构成合并NAFLD的危险因素。
