Objective To investigate the levels of inflammatory factors, oxidative stress and thioredoxin interacting protein (TXNIP) in patients with type 2 diabetes mellitus complicated by non alcoholic fatty liver, and to explore their correlation.Methods A total of 102 patients with non-alcoholic fatty liver were divided into normal blood glucose group (fasting blood glucose <6.1 mmol/L, and postprandial blood glucose <7.8mmol/L), abnormal glucose tolerance group (fasting blood glucose 6.1 ~6.9mmol/L, or 2h postprandial blood glucose 7.8 ~11.0mmol/L), type 2 diabetes group (fasting blood glucose ≥7. 0mmol/L, and 2h postprandial blood glucose≥11. 1mmol/L). The levels of inflammatory cytokines including C reaction protein(CRP),interleukin 1β(IL-1β),interleukin 6(IL-6),tumor necrosis factor α(TNF-α),and adiponectin and oxidative stress indexes including reduced glutathione (GSH), superoxide dismutase (T-SOD), glutathione peroxidase (GSH-Px), catalase (CAT) as well as TXNIP levels were observed and compared among the three groups. Results The levels of CRP,IL 1β,IL-6 and TNF-α in abnormal glucose tolerance group and type 2 diabetes group were significantly higher than those in normal blood glucose group,however, the adiponectin levels were significantly lower than those in normal blood glucose group (P<0.05).The levels of CRP, IL-1β, IL-6 and TNF-α in type 2diabetes group were significantly higher than those in normal blood glucose group and abnormal glucose olerance group,but adiponectin levels were significantly lower than those in normal glucose group and abnormal glucose tolerancegroup (P<0.05).There were no significant differences in IL1β levels between normal blood glucose group and abnormal glucose tolerance group(P>0.05). Moreover GSH levels in abnormal glucose tolerance group and type 2 diabetes group were significantly higher than those in normal blood glucose group,however,the levels of T-SOD,GSH-Px and CAT were significantly lower than those in normal blood glucose group(P<0.05).The levels of T-SOD,GSH-Px and CAT in type 2 diabetes group were significantly lower than those in abnormal glucose tolerance group(P<0.05),but there were no significant differences in GSH levels between the two groups (P>0.05). In addition the TXNIP levels in abnormal glucose tolerance group and type 2 diabetes mellitus group were significantly higher than those in normal blood glucose group, and TXNIP level in type 2 diabetes group were significantly higher than those in abnormal glucose tolerance group (P<0.05). Pearson correlation analysis showed that TXNIP levels were positively correlated with those of CRP,IL-6,TNF-α and GSH,however,which were negatively correlated with those of adiponectin,T-SOD,GSH-Px and CAT (P <0.05). The multiple linear stepwise regression analysis by using TXNIP as dependent variables,taking CRP, IL-6, TNF-α, GSH, adiponectin, T-SOD, GSH-Px and CAT as independent variables showed that TXNIP levels were positively correlated with those of CRP,IL-6 and TNF-α(P<0.05) after eliminating multiple factors interaction effect. Conclusion The patients with non-alcoholic fatty liver complicated by abnormal glucose tolerance and the patients with type 2 diabetes mellitus have obvious inflammatory reactions and oxidative stress injury. TXNIP may be involved in the pathogenetic process of type 2 diabetes mellitus combined with non-alcoholic fatty liver.%目的 研究2型糖尿病合并非酒精性脂肪肝患者炎性因子、氧化应激、硫氧还蛋白互作蛋白(TXNIP)水平,并探讨其相关性.方法 102例非酒精性脂肪肝患者分为血糖正常组(空腹血糖<6.1 mmol/L,餐后2 h血糖<7.8 mmol/L)、糖耐量异常组(空腹血糖6.1~6.9 mmol/L,或餐后2 h血糖7.8~11.0 mmol/L)、2型糖尿病组(空腹血糖≥7.0 mmol/L,餐后2 h血糖≥11.1 mmol/L).观察3组患者炎性因子[C-反应蛋白(CRP)、白介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)、脂联素]、氧化应激[还原型谷胱甘肽(GSH)、超氧化物歧化酶T-SOD、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)]、TXNIP水平,并对其进行相关性分析.结果 糖耐量异常组和2型糖尿病组CRP、IL-6、TNF-α水平均高于血糖正常组,脂联素水平低于血糖正常组,差异均有统计学意义(P<0.05).2型糖尿病组CRP、IL-1β、IL-6、TNF-α水平均高于血糖正常组和糖耐量异常组,脂联素水平低于血糖正常组和糖耐量异常组,差异均有统计学意义(P<0.05).糖耐量异常组IL-1β水平与血糖正常组比较,差异无统计学意义(P>0.05).糖耐量异常组、2型糖尿病组GSH水平高于血糖正常组,T-SOD、GSH-Px、CAT水平低于血糖正常组,差异均有统计学意义(P<0.05).2型糖尿病组T-SOD、GSH-Px、CAT水平低于糖耐量异常组,差异均有统计学意义(P<0.05),2组GSH水平比较,差异无统计学意义(P<0.05).糖耐量异常组、2型糖尿病组TXNIP水平高于血糖正常组,2型糖尿病组TXNIP水平高于糖耐量异常组,差异均有统计学意义(P<0.05).Pearson相关性分析表明,TXNIP水平与CRP、IL-6、TNF-α、GSH水平呈正相关,与脂联素、T-SOD、GSH-Px和CAT呈负相关(P<0.05).以TXNIP为应变量,CRP、IL-6、TNF-α、GSH、脂联素、T-SOD、GSH-Px和CAT为自变量进行多重线性逐步回归分析,结果显示,在排除多种因素相互影响后, TXNIP与CRP、IL-6和TNF-α呈正相关(P<0.05).结论 合并非酒精性脂肪肝糖耐量异常和2型糖尿病患者均有明显的炎性反应,且有氧化应激损伤,TXNIP可能参与了2型糖尿病合并非酒精性脂肪肝的发病过程.
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