2型糖尿病合并非酒精性脂肪肝患者血清小而密低密度脂蛋白变化及与胰岛素抵抗脂肪衰减指数的关系分析

doi:10.3969/j.issn.1006-6233.2023.11.021

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摘要 目的: 探究2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者血清小而密低密度脂蛋白(sdLDL-C)变化及与胰岛素抵抗、脂肪受控衰减指数(CAP)的关系。方法: 回顾性分析2023年3月至2023年4月我院收治的61例单纯T2DM患者临床资料纳入T2DM组;回顾性分析同期我院收治的48例T2DM合并NAFLD患者临床资料,纳入T2DM/NAFLD组。分析两组患者性别、年龄、腰臀比、T2DM病程、体质指数(BMI)、血压[舒张压(DBP)、收缩压(SBP)]等一般资料,比较两组患者入院时脂质代谢指标[sdLDL-C、CAP、总胆固醇(TC)、甘油三酯(TG)]、糖代谢指标[空腹血糖(FPG)、糖化血红蛋白(HbAIc)、胰岛素抵抗指数(HOMA-IR)],采用Pearson相关性分别分析T2DM合并NAFLD患者血清TC、TG、sdLDL-C与HOMA-IR、CAP的关系。结果: T2DM合并NAFLD患者BMI、脂质代谢指标(TC、TG、sdLDL-C、CAP)及糖代谢指标(FPG、HbAIc、HOMA-IR)水平均高于单纯T2DM患者(P均<0.05);Pearson相关性分析显示,T2DM合并NAFLD患者sdLDL-C水平与HOMA-IR、CAP水平呈正相关(P均<0.05)。结论: T2DM合并NAFLD患者血清sdLDL-C水平升高,且与胰岛素抵抗及CAP密切相关。

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关键词 ： 2型糖尿病, 非酒精性脂肪肝, 血清小而密低密度脂蛋白, 胰岛素抵抗, 脂肪衰减指数

Abstract：Objective: To explore the changes of serum small and dense low-density lipoprotein cholesterol (sdLDL-C) in patients with type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) and the relationship with insulin resistance and fat controlled attenuation parameter (CAP). Methods: The clinical data of 61 patients with uncomplicated T2DM admitted to the hospital between March 2023 and April 2023 were retrospectively analyzed and included in the T2DM group.The clinical data of 48 patients with T2DM complicated by NAFLD,admitted to the hospital during the same period,were retrospectively analyzed and included in the T2DM/NAFLD group.General patient data,such as gender,age,waist-to-hip ratio,T2DM duration,body mass index (BMI),and blood pressure (diastolic and systolic) were analyzed in both groups.Lipid metabolism indicators (sdLDL-C,CAP,total cholesterol,triglycerides) and glucose metabolism indicators (fasting plasma glucose,glycosylated hemoglobin,homeostasis model assessment of insulin resistance) were compared between the two groups at admission.Pearson correlation analysis was used to evaluate the relationship between serum total cholesterol,triglycerides,sdLDL-C,and insulin resistance (HOMA-IR) and CAP in T2DM patients with NAFLD. Results: Patients in the T2DM/NAFLD group had higher levels of BMI,lipid metabolism indicators (total cholesterol,triglycerides,sdLDL-C,CAP),and glucose metabolism indicators (fasting plasma glucose,glycosylated hemoglobin,HOMA-IR) compared to those with uncomplicated T2DM (all P<0.05).Pearson correlation analysis showed that the sdLDL-C level in T2DM patients with NAFLD was positively correlated with HOMA-IR and CAP levels (all P<0.05). Conclusion: Serum sdLDL-C levels are elevated in T2DM patients with NAFLD and are closely associated with insulin resistance and CAP.

Key words： Type 2 diabetes mellitus Non-alcoholic fatty liver disease Serum small and dense low-density lipoprotein cholesterol Insulin resistance Fat attenuation index

基金资助:山西省卫生健康委科研项目,(编号:2020160)

引用本文:

闫炜, 郭丹, 孙晓婷. 2型糖尿病合并非酒精性脂肪肝患者血清小而密低密度脂蛋白变化及与胰岛素抵抗脂肪衰减指数的关系分析[J]. 河北医学, 2023, 29(11): 1868-1872.
YAN Wei, et al. Changes of Serum Small and Dense Low-Density Lipoprotein Cholesterol and Relationship with Insulin Resistance and Fat Attenuation Index in Patients with T2DM and NAFLD. HeBei Med, 2023, 29(11): 1868-1872.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.11.021 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I11/1868