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目的分析2型糖尿病合并非酒精性脂肪肝患者植物甾醇日均摄入量与糖脂代谢的相关性。方法 2型糖尿病患者(A组)、2型糖尿病合并非酒精性脂肪肝患者(B组)、健康志愿者(C组)各50例。记录三组身高、体质量、BMI、收缩压、舒张压,计算每天摄入植物甾醇的均值。抽取空腹静脉血检测血糖、尿酸(UA)、尿素氮(BUN)、血清肌酐(sCr)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(HbA1c)、AST、ALT。进行糖耐量试验、胰岛素释放试验及C肽释放试验,胰岛素抵抗(IR)的评估采用胰岛素抵抗指数(HOMA-IR)。结果与A组比较,B组的BMI、TG、TC、LDL、ALT、AST、HOMA-IR、基础胰岛素分泌值高于A组(P均<0.05)。A、B组葡萄糖耐受试验、胰岛素释放试验及C肽释放试验高峰值较C组延迟。A、B组植物甾醇日均摄入量较C组下降,且B组低于A组(P均<0.05)。A、B组的植物甾醇日均摄入量与HDL均呈正相关,与BMI、TG、TC、LDL、ALT、AST、HOMA-IR值、尿酸、0、30、60、120、180 min血糖呈负相关;以植物甾醇日均摄入量为因变量,TG、HOMA-IR是植物甾醇摄入量的独立影响因素。结论 2型糖尿病合并非酒精性脂肪肝患者植物甾醇日均摄入量低于正常,可能与患者糖脂代谢紊乱的发生有关。
Objective To analyze the correlation between daily intake of phytosterols and glucose and lipid metabolism in type 2 diabetic patients with non-alcoholic fatty liver disease. Methods Fifty patients with type 2 diabetes mellitus (group A), type 2 diabetes mellitus patients with non - alcoholic fatty liver (group B) and healthy volunteers (group C). Record three groups of height, body mass, BMI, systolic blood pressure, diastolic blood pressure, daily intake of phytosterols mean. Fasting venous blood samples were collected for blood glucose, uric acid (UA), blood urea nitrogen (BUN), serum creatinine (sCr), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein LDL), glycosylated hemoglobin (HbA1c), AST, ALT. Glucose tolerance test, insulin release test and C peptide release test were performed. Insulin resistance (IR) was assessed by insulin resistance index (HOMA-IR). Results Compared with group A, BMI, TG, TC, LDL, ALT, AST, HOMA-IR and basal insulin secretion in group B were higher than those in group A (all P <0.05). Glucose tolerance test, insulin release test and C peptide release test in group A and group B were delayed compared with group C. The daily intake of phytosterols in groups A and B was lower than that in group C, and the level of phytosterols in group B was lower than that in group A (P <0.05). The daily intake of phytosterols in groups A and B was positively correlated with HDL, and was positively correlated with the levels of BMI, TG, TC, LDL, ALT, AST, HOMA-IR, uric acid, 0,30,60,120,180 min Negative correlation; the daily intake of phytosterols as the dependent variable, TG, HOMA-IR is an independent factor affecting phytosterol intake. Conclusions The average daily intake of phytosterols in type 2 diabetic patients with non-alcoholic fatty liver disease is lower than normal, which may be related to the disorder of glucose and lipid metabolism in patients with type 2 diabetes mellitus.