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目的研究2型糖尿病(type 2diabetes mellitus,T2DM)合并非酒精性脂肪性肝病(non-alcoholic fattyliver disease,NAFLD)患者血浆脂肪细胞特异性脂肪酸结合蛋白(adipocyte-specific fatty acid-binding protein,A-FABP)的水平及其相关因素。方法 2009年10月～2010年10月选取T2DM合并NAFLD组(A组)60例,未合并NAFLD组56例(B组)为研究对象。测定体质量指数(body mass index,BMI),检测血脂、糖化血红蛋白(hemoglobinA1c,HbA1c)等生化指标。放射免疫法测定空腹胰岛素(fasting insulin,FINS),空腹C肽水平(fasting C-peptide,FCP),计算胰岛素抵抗指数(homeostasis model of assessment-insulin resistance,HOMA-IR)、胰岛素敏感指数(insulin sensitivity index,ISI),测定A-FABP、C反应蛋白(C-reaction protein,CRP)及肿瘤坏死因子-α(tumor necrosisfactor-α,TNF-α)。结果与B组患者相比,A组患者其血浆A-FABP水平、BMI、腰围、腰臀比、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、CRP、TNF-α、FCP、FINS、总胆固醇、甘油三酯、Ln(HOMA-IR)升高,Ln(ISI)降低,差异有统计学意义(P<0.05);两组HbA1c差异无统计学意义(P>0.05)。A-FABP水平变化与TNF-α、HOMA-IR、CRP呈正相关,与ISI呈负相关。结论 T2DM伴NAFLD中,A-FABP升高与胰岛素抵抗是并存的,且存在明显相关关系,二者在疾病的发生发展中均可能具有重要的作用。
Objective To investigate the expression of plasma adipocyte-specific fatty acid-binding protein (A-FABP) in patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) ) Level and its related factors. Methods From October 2009 to October 2010, 60 T2DM patients with NAFLD (group A) and 56 patients without NAFLD (group B) were enrolled in this study. Body mass index (BMI), blood lipid, hemoglobin A1c (HbA1c) and other biochemical parameters were measured. The levels of fasting insulin (FINS), fasting C-peptide (FCP), homeostasis model of assessment-insulin resistance (HOMA-IR), insulin sensitivity index, ISI) were used to detect A-FABP, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α). Results Compared with patients in group B, the levels of A-FABP, BMI, waist circumference, waist-hip ratio, alanine aminotransferase, aspartate aminotransferase, CRP, TNF-α, FCP, FINS , Total cholesterol, triglyceride, Ln (HOMA-IR) increased, Ln (ISI) decreased, the difference was statistically significant (P <0.05). There was no significant difference in HbA1c between the two groups (P> 0.05). The level of A-FABP was positively correlated with TNF-α, HOMA-IR and CRP, but negatively correlated with ISI. Conclusions There is a significant correlation between elevated A-FABP and insulin resistance in T2DM with NAFLD, which may play an important role in the development of the disease.