天津医药

天津医药 ›› 2014, Vol. 42 ›› Issue (12): 1205-1212.doi: 10.3969/j.issn.0253-9896.2014.12.016

• 临床研究 • 上一篇    下一篇

血浆sCD36与2型糖尿病非酒精性脂肪肝的关系

杨玲1,贾国瑜2,王璐2,李强2,张洁2,谢春晓1,邸阜生3   

  1. 1. 天津医科大学三中心临床学院
    2. 天津市第三中心医院
    3. 天津市第三中心医院内分泌科
  • 收稿日期:2014-07-10 修回日期:2014-08-14 出版日期:2014-12-15 发布日期:2014-12-15
  • 通讯作者: 杨玲 E-mail:yangling517@yeah.net
  • 基金资助:
    天津市卫生局科技基金重点资助项目

Relationship between Plasma sCD36 and Type 2 Diabetes Mellitus with Nonalcoholic Fatty Liver Disease

Ling YANG1,JIA Guoyu 2,WANG Lu 2,LI Qiang 2,ZHANG JIE 2,XIE Chunxiao 1,DI Fushen 2   

  1. 1. The Third Central Clinical Medical College of Tianjin Medical University, Tianjin 300170, China
    2. Tianjin Third CentralHospital; Key Laboratory of Regenerative Medicine
  • Received:2014-07-10 Revised:2014-08-14 Published:2014-12-15 Online:2014-12-15
  • Contact: Ling YANG E-mail:yangling517@yeah.net

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摘要：

【摘要】 目的 研究血浆可溶性 CD36（sCD36）与 2 型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）的关系。 方法 检测正常对照组（A 组， 39 例）、T2DM 未合并 NAFLD 组（B 组， 39 例）和 T2DM 合并 NAFLD 组（C 组， 59 例）患者的血浆 sCD36 水平， 计算 C 组的肝脏脂肪含量（LFC）及 NAFLD 纤维化评分（NFS）， 测定上述 3 组糖脂代谢指标、肝功能指标及炎症指标。 方差分析法比较上述指标在 3 组中的差异； 相关分析法分析 C 组患者上述各项指标与 sCD36 的相关性； 多元逐步回归法分析 C 组 sCD36 的影响因素。 结果 血浆 sCD36（μg/L）水平在 B 组（3.87± 1.16）、C 组（5.72±1.79）均高于 A 组（2.57±0.93）， 且 C 组高于 B 组（均 P＜ 0.01）； 相关分析示 C 组的 sCD36 水平与体质量指数（BMI）、腰围、内脏脂肪面积、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、游离脂肪酸（FFA）、丙氨酸转氨酶（ALT）、肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、LFC、NFS 呈正相关（均 P＜ 0.05）， 多元逐步回归分析示 FFA、LFC、TNF-α、IL-6 是 sCD36 的影响因素。 结论 血浆 sCD36 与脂肪肝严重程度、肝脏损伤以及脂肪性肝纤维化有关， 可能成为 T2DM 合并 NAFLD 的血浆标志物， CD36 可能通过炎症机制参与 T2DM 合并 NAFLD 的发生发展。

关键词: 糖尿病, 2型, 脂肪肝, 可溶性CD36, 炎症, 肝损伤, 肝纤维化

Abstract:

[Abstract] Objective To investigate the relationship between plasma soluble CD36 (sCD36) and nonalcoholic fatty liver disease (NAFLD) in patients combined with type 2 diabetes mellitus (T2DM). Methods Plasma levels of sCD36 were determined in normal control group (group A, n=39), patients of T2DM without NAFLD group (group B, n=39) and T2DM with NAFLD group (group C, n=59). Liver fat content (LFC) and nonalcoholic fatty liver fibrosis score (NFS) were calculated in group C. Glucose and lipid metabolic parameters, liver function parameters and inflammatory parameters were also detect? ed in all three groups. Variance analysis was applied to analyze the differences of the above parameters among three groups; Correlation analysis was used to analyze the relationship between sCD36 level and all the above parameters; Multiple step?wise regression analysis was applied to determine the influencing factors of sCD36 level in patients of group C. Results Plasma sCD36 (μg/L) levels in group B (3.87±1.16) and group C (5.72±1.79) are higher than that of group A (2.57±0.93) (both P < 0.01), and it is higher in group C than in group B (each P < 0.05); Correlation analysis showed that sCD36 level was positively correlated with body mass index (BMI), waist, visceral adipose tissue， fast insulin (FINS), insulin resistance in? dex (HOMA-IR), free fatty acid (FFA), alanine transaminase (ALT), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), LFC and NFS (P < 0.01 or P < 0.05); Multiple stepwise regression analysis showed that FFA, LFC, TNF-αand IL-6 were in? fluencing factors of sCD36 level in patients of group C. Conclusion Plasma sCD36 level was related to fatty liver severity, liver injury and fatty liver fibrosis, it might be used as a plasma marker of T2DM combined with NAFLD. CD36 might con? tribute to the development of T2DM combined with NAFLD through inflammatory mechanisms.

Key words: diabetes mellitus, type 2, fatty liver, soluble CD36, inflammation, liver injury, liver fibrosis