ApoB/ApoA1比值及non-HDL-C与2型糖尿病合并非酒精性脂肪肝病的相关性

摘要

目的 探讨2型糖尿病患者载脂蛋白B(ApoB)和载脂蛋白A1(ApoA1)的比值、非高密度脂蛋白胆固醇(non-HDL-C)与非酒精性脂肪肝病(NAFLD)的关系.方法 208例2型糖尿病患者按有无合并非酒精性脂肪肝病分为未合并非酒精性脂肪肝病组(non-NAFLD组)和合并非酒精性脂肪肝病组(NAFLD组),所有患者均检测空腹血糖、空腹胰岛素、血脂、糖化血红蛋白等指标,同时记录糖尿病病程、身高、体质量、腰围等临床一般资料,计算ApoB/ApoA1比值及non-HDL-C,比较两组之间的指标差异并进行Logistic回归分析及ROC曲线分析.结果 NAFLD组的ApoB/ApoA1比值、non-HDL-C、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白、体质量指数、腰围均高于non-NAFLD组,差异有统计学意义(P＜0.05).Logistic回归分析结果显示,ApoB/ApoA1比值及non-HDL-C均为影响2型糖尿病患者发生非酒精性脂肪肝病的独立危险因素.ROC曲线分析结果显示,ApoB/ApoA1比值及non-HDL-C预测合并NAFLD的曲线下面积分别为0.795,0.709(P＜0.05);进一步比较两者曲线下面积,行Z检验结果显示两者间差异无统计学意义(P＞0.05).结论 ApoB/ApoA1比值、non-HDL-C均为影响2型糖尿病患者发生非酒精性脂肪肝病的独立危险因素,两者对2型糖尿病合并非酒精性脂肪肝病均具有良好的预测价值.%Objective To investigate the relationship between the ratio of apolipoprotein B to apolipoprotein A1 (ApoB/ApoA1 ratio),non-high density lipoprotein cholesterol (non-HDL-C) and non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients.Methods Totally 208 T2DM patients were classified as non-NAFLD group and NAFLD group.Fasting blood glucose,fasting insulin,blood lipid and glycosylated hemoglobin of all the patients were measured.Diabetes duration,height,and waist circumference were recorded.The ApoB/ApoA1 ratio and non-HDL-C were calculated.The indexes between the two groups were compared and analyzed by Logistic regression analysis and ROC curve analysis.Results The ApoB/ApoA1 ratio,non-HDL-C,triglyceride,total cholesterol,low density lipoprotein,fasting blood glucose,glycosylated hemoglobin,body mass index and waist circumference were significantly higher in NAFLD group than in non-NAFLD group (P ＜ 0.05).Logistic regression analysis showed that the ApoB/ApoA1 ratio and the level of non-HDL-C were independent risk factors of NAFLD in T2DM patients.The areas under the ROC curve of ApoB/ApoA1 ratio and level of non-HDL-C to predict NAFLD were 0.795 and 0.709,respectively (P ＜ 0.05).Further comparison of the areas under the ROC curve using the Z test showed no statistically significant difference between ApoB/ApoA1 ratio and the level of non-HDL-C (P ＞ 0.05).Conclusion The ApoB/ApoA1 ratio and the level of non-HDL-C are the independent risk factors,and may be better markers for predicting NAFLD in T2DM patients.