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目的探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者的内皮素-1(ET-1)与胰岛素抵抗(IR)的相关性。方法将99例T2DM患者分为单纯糖尿病组(A组)51例,合并NAFLD组(B组)48例,分别测定身高、体重、收缩压(SBP)、舒张压(DBP),抽空腹血检查内皮素-1(ET-1)、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白A1c(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)。并计算体重指数(BMI)、胰岛素抵抗指数(HOMA-IR)、胰岛素作用指数(IAI)及定量胰岛素敏感性指数(QUICKI)。结果 B组的体重、BMI、FINS、HOMA-IR、ET-1、SBP、DBP、ALT、AST、GGT均明显高于A组(P<0.05),IAI、QUICKI明显低于A组(P<0.05)。两组之间年龄、HbA1c、FPG、TC、TG、HDL-C、LDL-C差异无统计学意义。Pearson相关分析结果显示,ET-1与体重、BMI、FINS、HOMA-IR呈显著正相关(P<0.01),与IAI、QUICKI呈显著负相关(P<0.01)。结论 T2DM合并NAFLD患者ET-1水平升高,IR程度明显加重。因此,T2DM合并NAFLD患者更需及早进行内皮功能障碍与IR干预,预防动脉粥样硬化的发生。
Objective To investigate the relationship between endothelin-1 (ET-1) and insulin resistance (IR) in type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD). Methods Fifty-nine patients with T2DM were divided into two groups: 51 cases of simple diabetic group (A group) and 48 cases of NAFLD group (Group B). The body height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP) ET-1, FPG, FINS, HbA1c, TC, TG, HDL- C, LDL-C, ALT, AST, GGT. Body mass index (BMI), insulin resistance index (HOMA-IR), insulin action index (IAI) and quantitative insulin sensitivity index (QUICKI) were calculated. Results The body weight, BMI, FINS, HOMA-IR, ET-1, SBP, DBP, ALT, AST and GGT in group B were significantly higher than those in group A, IAI and QUICKI were significantly lower than those in group A (P < 0.05). There was no significant difference in age, HbA1c, FPG, TC, TG, HDL-C and LDL-C between the two groups. Pearson correlation analysis showed that there was a significant positive correlation between ET-1 and body weight, BMI, FINS and HOMA-IR (P <0.01), but negative correlation with IAI and QUICKI (P <0.01). Conclusion The level of ET-1 in patients with T2DM complicated with NAFLD is increased, and the degree of IR is significantly increased. Therefore, T2DM patients with NAFLD need to be as early as possible endothelial dysfunction and IR intervention to prevent the occurrence of atherosclerosis.