医学分子生物学杂志 ›› 2024, Vol. 21 ›› Issue (3): 270-274.doi: 10.3870/j.issn.1672-8009.2024.03.013

• 论著 • 上一篇    下一篇

LECT2、 FGF21 水平在 T2DM 伴 NAFLD 患者中的变化及其临床意义 #br#

  

  1. 中国人民解放军西部战区总医院1 门诊部体检中心,2 门诊部,3 第一派驻门诊部 成都市, 610000
  • 出版日期:2024-05-31 发布日期:2024-06-14
  • 基金资助:
    四川省科技厅应用基础研究重点项目 (No. 2019YJ0274)

Changes of LECT2 and FGF21 Levels in T2DM Patients Complicated with NAFLD and Their Clinical Significance #br#

  1. 1Physical Examination Cencer of Outpatient Department,2Outpatient Department,3The First Outpatient Department, General Hospital of the Western Theater Command, Chengdu, 610000, China
  • Online:2024-05-31 Published:2024-06-14

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摘要： 目的 探讨血清白细胞衍生趋化因子 2 (leukocyte cell derived chemotaxin 2, LECT2)、 成纤维细胞生长因子 21 (fibroblast growth factor 21, FGF-21) 在 2 型糖尿病 (diabetes mellitus type 2, T2DM) 伴非酒精性脂肪性肝病 (non-alchoholic fatty liver disease, NAFLD) 患者中的变化及临床意义。 方法 选取中国人民解放军西部战区总医院 2019 年 10 月 ~ 2021 年 10 月收治的 T2DM 患者 142 例, 按是否合并 NAFLD 分为伴 NAFLD 组 (68 例) 与无 NAFLD 组 (74 例), 收集患者临床指标, 采用酶联免疫吸附法检测 LECT2、FGF-21 水平。 比较两组临床指标差异, 分析 LECT2、 FGF-21 水平与其他临床指标的相关性, 采用 Logistic回归分析 T2DM 伴 NAFLD 的独立影响因素; 采用 ROC 曲线分析各变量预测 T2DM 伴 NAFLD 的效能。 结果 伴 NAFLD 组 BMI、 WHR、 SBP、 DBP、 FPG、 FINS、 FCP、 HbAlc、 HOMA-IR、 TC、 TG、 LDL-C、 ALT、AST、 GGT、 LECT2、 FGF21 高于无 NAFLD 组, HOMA-β、 HDL-C 低于无 NAFLD 组 ( P< 0. 05); 相关分析显示, LECT2 与 BMI、 WHR、 FPG、 FINS、 FCP、 HbAlc、 HOMA-IR、 TC、 GGT 存在正相关, 与 HOMA-β、HDL-C 存在负相关 ( P< 0. 05); FGF21 与 FPG、 FINS、 FCP、 HbAlc、 HOMA-IR、 TC、 TG 存在正相关, 与HOMA-β、 HDL-C 存在负相关 ( P < 0. 05); Logistic 分析, 结果显示, HOMA-IR、 HDL-C、 LECT2、 FGF21是 T2DM 伴 NAFLD 的独立影响因素 (P< 0. 05); ROC 曲线分析显示, LECT2、 FGF21 预测 T2DM 伴 NAFLD的最佳截断值为 30. 72 ng / ml、 138. 66 ng / L, 灵敏度为 72. 61 % 、 71. 36 % , 特异度为 72. 54 % 、 73. 75 % ,AUC 值为 0. 732、 0. 753 (P< 0. 001), 两项指标联合检测灵敏度为 85. 72 % 、 特异度为 87. 44 % , AUC 值为 0. 863 (P< 0. 001)。 结论 LECT2、 FGF-21 与胰岛素抵抗及血脂水平存在相关, 可作为预测 T2DM 伴NAFLD 的指标。

关键词: 白细胞衍生趋化因子 2, 成纤维细胞生长因子 21, 糖尿病, 非酒精性脂肪性肝病

Abstract: Objective To investigate the changes and clinical significance of serum leukocytederived chemotaxin 2 (LECT2) and fibroblast growth factor 21 (FGF-21) in patients with type 2diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease ( NAFLD). Methods A total of 142 T2DM patients admitted to the General Hospital of the Western Theater Region of the People’s Liberation Army of China from October 2019 to October 2021 were divided into 2 groups according to whether complicated with NAFLD: with-NAFLD group (68 cases) and without-NAFLD group (74 cases). Clinical indicators of the patients were collected, and the levels of LECT2 and FGF-21 were detected by ELISA. The differences in clinical indicators between the two groups were compared, and the correlations between the levels of LECT2 and FGF-21 and the other clinical indicators were analyzed. Logistic regression analysis was used to analyze the independent influencing factors of T2DM with NAFLD. ROC curve was used to analyze the efficacy of each variable in predicting T2DM with NAFLD. Results The values of BMI, WHR, SBP, DBP, FPG, FINS, FCP,HbAlc, HOMA-IR, TC, TG, LDL-C, ALT, AST, GGT, LECT2 and FGF21 in the withNAFLD group were higher than those in the without-NAFLD group, the values of HOMA-β andHDL-C were lower than those in the without-NAFLD group (P< 0. 05). Correlation analysis showedthat the level of LECT2 was positively correlated with the values of BMI, WHR, FPG, FINS, FCP, HbAlc, HOMA-IR, TC, GGT, and was negatively correlated with the values of HOMA-βand HDL-C (P<0. 05). The level of FGF21 was positively correlated with the values of FPG, FINS,FCP, HbAlc, HOMA-IR, TC and TG, but negatively correlated with the values of HOMA-β andHDL-C (P<0. 05). Logistic analysis showed that HOMA-IR, HDL-C, LECT2 and FGF21 were independent influencing factors of T2DM with NAFLD (P<0. 05). ROC curve analysis showed that theoptimal truncation values of LECT2 and FGF21 for predicting T2DM with NAFLD were 30. 72 ng / mL and 138. 66 ng / L, with 72. 61 % and 71. 36 % sensitivity and 72. 54 % and 73. 75 % specificity, respectively. The AUC values for LECT2 and FGF21 were 0. 732 and 0. 753, respectively. And the combined sensitivity, specificity and AUC values were 85. 72 % , 87. 44 % and 0. 863, respectively(P<0. 001). Conclusion LECT2 and FGF-21 are correlated with insulin resistance indicators andlipid levels, which can be used as indicators to predict T2DM with NAFLD.

Key words:

leukocyte derived chemotaxin 2, fibroblast growth factor 21, diabetes, non-alcoholic fatty liver disease

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