2型糖尿病合并非酒精性脂肪性肝病患者血清胎球蛋白B水平变化及影响因素分析
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摘要
目的观察T2DM合并非酒精性脂肪性肝病(NAFLD)患者血清胎球蛋白B(Fetuin-B)水平,并分析其影响因素。方法选取2015年1月至2016年1月于我院内分泌科就诊的T2DM合并NAFLD患者(T2DM+NAFLD组)83例、单纯T2DM患者(T2DM组)81例和同期于我院健康体检者(NC组)80名。ELISA检测各组血清Fetuin-B水平。Pearson相关分析Fetuin-B与其他指标的相关性,多元线性回归分析Fetuin-B的影响因素,Logistic回归分析T2DM合并NAFLD患者的危险因素。结果 (1)T2DM+NAFLD组、T2DM组和NC组WC、FPG、2 hPG、HbA1c、TG、HOMA-IR、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)及Fetuin-B水平依次降低,HOMA-β依次升高(P<0. 05或P<0. 01);(2)Pearson相关分析显示,血清Fetuin-B与WC、BMI、FPG、2 hPG、HbA1c、TG及HOMA-IR呈正相关(r=0. 224、0. 256、0. 385、0. 358、0. 296、0. 247、0. 462,P<0. 05或P<0. 01),与HOMA-β呈负相关(r=-0. 206,P<0. 05);(3)多元线性回归分析结果显示,WC、BMI及HbA1c是血清Fetuin-B水平的影响因素(P=0. 000);(4)Logistic回归分析结果显示,Fetuin-B是T2DM合并NAFLD患者的危险因素(P=0. 000)。结论 T2DM患者血清Fetuin-B水平升高,而T2DM合并NAFLD患者升高更显著,Fetuin-B可能是T2DM合并NAFLD患者的危险因素。
ObjectiveTo investigate the level changes of serum Fetuin-B in patients with type 2 diabe-tes(T2 DM)and non-alcoholic fatty liver disease(NAFLD),and analyze its influencing factors.Methods A total of 244 subjects were enrolled in this study from January 2015 to January 2016 in our hospital. All the subjects were divided into three groups:T2 DM combined with NAFLD(T2 DM +NAFLD group,n=83),T2 DM patients(T2 DM group,n=81)and healthy controls(NC group,n=80). Serum Fetuin-B level was measured by ELISA. Pearson correlation analysis was used to analyze the correlation between Fe-tuin-B and other indexes. Multivariate linear regression analysis was used to analyze the influencing factors for Fetuin-B. Logistic regression analysis was used to analyze the risk factors for patients with T2 DM and NAFLD.Results(1)The levels of WC,FPG,2 hPG,HbA1 c,TG,HOMA - IR,ALT,AST,GGT,and Fetuin-B decreased,while HOMA-β increased successively in T2 DM+NAFLD,T2 DM,and NC group(P<0. 05 or P<0. 01).(2)Pearson correlation analysis showed that serum fetuin-B was posi-tively correlated with WC,BMI,FPG,2 hPG,HbA1 c,TG and HOMA-IR(r=0. 224,0. 256,0. 385,0. 358,0. 296,0. 247,0. 462,P<0. 05 or P<0. 01),and negatively correlated with HOMA - β(r=-0. 206,P<0. 05).(3)Multiple linear regression showed that WC,BMI,and HbA1 c were influencing factors for serum Fetuin-B(P=0. 000).(4)Logistic regression analysis indicated that the fetuin-B was a risk factor for T2 DM combined with NAFLD(P<0. 01).ConclusionThe level of serum Fetuin-B in-creased in T2 DM patients,and it increased more seriously in T2 DM patients with NAFLD. Fetuin-B may be a risk factor for T2 DM combined with NAFLD.
ObjectiveTo investigate the level changes of serum Fetuin-B in patients with type 2 diabe-tes(T2 DM)and non-alcoholic fatty liver disease(NAFLD),and analyze its influencing factors.Methods A total of 244 subjects were enrolled in this study from January 2015 to January 2016 in our hospital. All the subjects were divided into three groups:T2 DM combined with NAFLD(T2 DM +NAFLD group,n=83),T2 DM patients(T2 DM group,n=81)and healthy controls(NC group,n=80). Serum Fetuin-B level was measured by ELISA. Pearson correlation analysis was used to analyze the correlation between Fe-tuin-B and other indexes. Multivariate linear regression analysis was used to analyze the influencing factors for Fetuin-B. Logistic regression analysis was used to analyze the risk factors for patients with T2 DM and NAFLD.Results(1)The levels of WC,FPG,2 hPG,HbA1 c,TG,HOMA - IR,ALT,AST,GGT,and Fetuin-B decreased,while HOMA-β increased successively in T2 DM+NAFLD,T2 DM,and NC group(P<0. 05 or P<0. 01).(2)Pearson correlation analysis showed that serum fetuin-B was posi-tively correlated with WC,BMI,FPG,2 hPG,HbA1 c,TG and HOMA-IR(r=0. 224,0. 256,0. 385,0. 358,0. 296,0. 247,0. 462,P<0. 05 or P<0. 01),and negatively correlated with HOMA - β(r=-0. 206,P<0. 05).(3)Multiple linear regression showed that WC,BMI,and HbA1 c were influencing factors for serum Fetuin-B(P=0. 000).(4)Logistic regression analysis indicated that the fetuin-B was a risk factor for T2 DM combined with NAFLD(P<0. 01).ConclusionThe level of serum Fetuin-B in-creased in T2 DM patients,and it increased more seriously in T2 DM patients with NAFLD. Fetuin-B may be a risk factor for T2 DM combined with NAFLD.
引文
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[2]朱宏,杨秋萍.胎球蛋白A与2型糖尿病和非酒精性脂肪性肝病的关系.中国综合临床,2016,32:1035-1037.
[3]郑刚.胎球蛋白A在心血管病诊治中的应用前景.中华临床医师杂志(电子版),2013,7:6069-6071.
[4] Dahlman I,Eriksson P,Kaaman M,et al. Alpha2-Heremans-Schmid glycoprotein gene polymorphisms are associated with adi-pocyte insulin action.Diabetologia,2004,47:1974-1979.
[5] EASL-EASD-EASO Clinical Practice Guidelines for themanage-ment of non-alcoholic fatty liver disease. J Hepatol,2016,64:1388-1402.
[6]郭玫,李红梅,刘瑛,等.对新诊断2型糖尿病患者合并脂代谢异常及非酒精性脂肪肝的探讨.中国糖尿病杂志,2013,21:229-231.
[7]许方圆,潘雨亭,尚文斌,等.胎球蛋白B在机体病理生理过程中的作用.生理科学进展,2017,48:274-278.
[8] Meex RC,Hoy AJ,Morris A,et al. Fetuin B is a secretedhepato-cyte factor linking steatosis to impaired glucose metabolism. Cell Metab,2015,22:1078-1089.
[9] Zhu J,Wan X,Wang Y,et al. Serum fetuin B level increased in subjects of nonalcoholic fatty liver disease:Acase-control study.Endocrine,2017,56:208-211.
[10]Choi JW,Liu H,Mukherjee R,et al. Downregulation offetuin-B and zinc-alpha2-glycoprotein is linked to impairedfatty acid metab-olism in liver cells. Cell PhysiolBiochem,2012,30:295-306.
[11]Peter A,Kovarova M,Staiger H,et al. The hepatokines Fetuin-A and Fetuin-B are up-regulated in the state of hepatic steatosis and may differently impact on glucose homeostasis in humans.Am J Physiol Endocrinol Metab,2018,314:E266-E273.
[2]朱宏,杨秋萍.胎球蛋白A与2型糖尿病和非酒精性脂肪性肝病的关系.中国综合临床,2016,32:1035-1037.
[3]郑刚.胎球蛋白A在心血管病诊治中的应用前景.中华临床医师杂志(电子版),2013,7:6069-6071.
[4] Dahlman I,Eriksson P,Kaaman M,et al. Alpha2-Heremans-Schmid glycoprotein gene polymorphisms are associated with adi-pocyte insulin action.Diabetologia,2004,47:1974-1979.
[5] EASL-EASD-EASO Clinical Practice Guidelines for themanage-ment of non-alcoholic fatty liver disease. J Hepatol,2016,64:1388-1402.
[6]郭玫,李红梅,刘瑛,等.对新诊断2型糖尿病患者合并脂代谢异常及非酒精性脂肪肝的探讨.中国糖尿病杂志,2013,21:229-231.
[7]许方圆,潘雨亭,尚文斌,等.胎球蛋白B在机体病理生理过程中的作用.生理科学进展,2017,48:274-278.
[8] Meex RC,Hoy AJ,Morris A,et al. Fetuin B is a secretedhepato-cyte factor linking steatosis to impaired glucose metabolism. Cell Metab,2015,22:1078-1089.
[9] Zhu J,Wan X,Wang Y,et al. Serum fetuin B level increased in subjects of nonalcoholic fatty liver disease:Acase-control study.Endocrine,2017,56:208-211.
[10]Choi JW,Liu H,Mukherjee R,et al. Downregulation offetuin-B and zinc-alpha2-glycoprotein is linked to impairedfatty acid metab-olism in liver cells. Cell PhysiolBiochem,2012,30:295-306.
[11]Peter A,Kovarova M,Staiger H,et al. The hepatokines Fetuin-A and Fetuin-B are up-regulated in the state of hepatic steatosis and may differently impact on glucose homeostasis in humans.Am J Physiol Endocrinol Metab,2018,314:E266-E273.