摘要
目的 探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者铁蛋白、甘油三酯葡萄糖体质指数(TyG-BMI)变化及与脂肪变性程度的相关性。方法 选取2021年1月至2022年7月本院收治的121例T2DM患者为研究对象,根据有无合并NAFLD分为合并组(n=81)和非合并组(n=40),比较两组铁蛋白、TyG-BMI水平及基线资料的差异,采用Logistic回归模型分析铁蛋白、TyG-BMI与T2DM合并NAFLD的关系,并采用受试者工作特征(ROC)曲线评估铁蛋白、TyG-BMI单独及联合应用对T2DM合并NAFLD的预测价值。以磁共振(MRI)肝脏质子密度脂肪分数(PDFF)检测结果作为脂肪变性程度的划分标准,比较不同脂肪变性程度患者铁蛋白、TyG-BMI水平,并采用Pearson法分析铁蛋白、TyG-BMI与PDFF水平的相关性。结果 合并组患者的腰臀比(WHR)、舒张压、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹C肽(FCP)、甘油三酯(TG)、丙氨酸转移酶(ALT)、γ-谷氨酰转移酶(GGT)、谷草转氨酶(AST)、尿酸(UA)、体质指数(BMI)、甘油三酯葡萄糖(TyG)、TyG-BMI及铁蛋白水平均高于未合并组,年龄、高密度脂蛋白胆固醇(HDL-C)低于未合并组(P<0.05)。Logistic回归分析显示,WHR、FCP、铁蛋白及TyG-BMI高水平均是T2DM合并NAFLD的危险因素(P<0.05)。ROC分析结果显示,铁蛋白、TyG-BMI单独及联合应用预测T2DM合并NAFLD的曲线下面积(AUC)(95%CI)分别为0.812(0.731~0.877)、0.828(0.749~0.891)、0.912(0.846~0.956),两者联合预测效能高于单独检测(P<0.05)。无脂肪变性患者比较,轻度、中度及重度脂肪变性患者铁蛋白、TyG-BMI水平均较高,且重度高于中度,中度高于轻度(P<0.05);Pearson分析显示,脂肪变性程度PDFF值与铁蛋白、TyG-BMI均呈显著正相关(r=0.574、0.654,P均<0.001)。结论 铁蛋白、TyG-BMI在T2DM合并NAFLD患者中升高,且与肝脂肪变性程度密切相关,可作为判断T2DM患者有无合并NAFLD的可靠指标。
Objective To investigate the changes in ferritin and triglyceride glucose body mass index(TyGBMI)and the correlation with steatosis degree in patients with type 2 diabetes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD).Methods 121 patients with T2DM admitted to the hospi-tal from January 2021 to July 2022 were selected for the study,and the patients were divided into com-bined group(n=81)and non-combined group(n=40)according to the presence or absence of combined NAFLD.The differences in ferritin,TyG-BMI levels and baseline data between the 2 groups were com-pared.Logistic regression model was used to analyse the relationship between ferritin,TyG-BMI and com-bined NAFLD in T2DM.The predictive value of ferritin and TyG-BMI alone and in combination for com-bined NAFLD in T2DM was also assessed with using subject operating characteristic(ROC)curves.The results of magnetic resonance(MRI)liver proton density fat fraction(PDFF)were used as the criterion to classify the steatosis degree,and the levels of ferritin and TyG-BMI in patients with different steatosis de-gree were compared,and the correlation between ferritin,TyG-BMI and PDFF levels were analysed with using the Pearson method.Results Patients in the combined group had higher waist-to-hip ratio(WHR),diastolic blood pressure,glycosylated hemoglobin(HbA1c),fasting insulin(FINS),fasting C-peptide(FCP),triglyceride(TG),alanine transferase(ALT),γ-glutamyltransferase(GGT),aspartate amin-otransferase(AST),uric acid(UA),body mass index(BMI),triglyceride glucose(TyG),TyG-BMI and ferritin levels than those in the uncombined group,and lower age and HDL-C than those in the uncom-bined group(P<0.05).Logistic regression analysis showed that high levels of WHR,FCP,ferritin and TyG-BMI were all risk factors for NAFLD in combination with T2DM(P<0.05).ROC analysis showed that the area under the curve(AUC)(95%CI)for ferritin and TyG-BMI alone and in combination to pre-dict NAFLD in T2DM combined was 0.812(0.731-0.877),0.828(0.749-0.891)and 0.912(0.846-0.956
作者
吴风
孔丽蕊
谭志群
WU Feng;KONG Lirui;TAN Zhiqun(Chinese Medicine Hospital,Pidu District Chengdu,Sichuan Province,621000,China;Maternal and Child Health Hospital,Pidu District Chengdu,Sichuan Province,621000,China)
出处
《新疆医科大学学报》
CAS
2023年第10期1338-1343,共6页
Journal of Xinjiang Medical University
基金
四川省医学会专项科研项目(2019R04)。
