2型糖尿病患者C肽与非酒精性脂肪肝的关系

C-Peptide and Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes

摘要: 背景：2型糖尿病和非酒精性脂肪肝(NAFLD)常常共同存在，并且可以通过协同作用导致不良结局，不仅会增加糖尿病并发症的发生风险，也会增加NAFLD进展为肝硬化、肝癌等风险。材料与方法：这是一项回顾性横断面研究，根据纳入排除标准，我们共纳入261名2型糖尿病患者。根据BMI分为肥胖组和非肥胖组。留取空腹血检测空腹血糖、空腹C肽、空腹胰岛素、糖化血红蛋白、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。结果：肥胖组的患者空腹血糖、HbA1c、空腹C肽、空腹胰岛素均显著高于非肥胖组(P < 0.05)。校正了性别、年龄、LDL、HDL、TC、TG后，Logistic回归显示，在肥胖组，空腹C肽的增加是发生NAFLD的危险因素(OR = 1.403, 95%CI (1.052, 1.871))，而在非肥胖组，没有观察到空腹C肽的增加与NAFLD之间的关系。此外，无论肥胖组还是非肥胖组，均没有观察到空腹胰岛素与NAFLD之间的关系。结论：随着空腹C肽的增加，肥胖型2型糖尿病患者发生NAFLD的风险增加，而在非肥胖型的2型糖尿病患者中，没有观察到C肽增加与NAFLD之间的关系。C肽的分泌与肥胖型2型糖尿病患者发生NAFLD密切相关，但仍然需要前瞻性的研究探索C肽与非酒精性脂肪肝之间的关系。

Abstract: Background: Type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) often coexist, and can lead to adverse outcomes. The synergistic effects not only increase the risk of diabetes complications, but also increase the risk of NAFLD developing into cirrhosis and liver cancer. Materials and methods: This is a retrospective cross-sectional study. According to the inclusion and exclusion criteria, we included a total of 261 patients with type 2 diabetes. According to BMI, they are divided into obese group and non-obese group. Blood samples were collected after fasting overnight. Detection indicators include fasting blood glucose, fasting C-peptide, fasting insulin, glycosylated hemoglobin, triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL). Results: The fasting blood glucose, HbA1c, fasting C-peptide, and fasting insulin of the obese group were significantly higher than those of the non-obese group (P < 0.05). After adjusting for gender, age, LDL, HDL, TC, TG, logistic regression showed that in the obese group, with the increasing of fasting C-peptide, the risk of NAFLD increased (OR = 1.403, 95%CI (1.052, 1.871)). While in the non-obese group, we didn’t observe the relationship between the increasing of fasting C-peptide and NAFLD. In addition, no matter whether the obese group or the non-obese group, the relationship between fasting insulin and NAFLD was not observed. Conclusion: With the increase of fasting C-peptide, the risk of NAFLD in obese type 2 diabetic patients increased, while in non-obese type 2 diabetic patients, no relationship between the increase in C-peptide and NAFLD was observed. The secretion of C-peptide is closely related to the occurrence of NAFLD in obese type 2 diabetic patients, but prospective studies are still needed to explore the relationship between C peptide and non-alcoholic fatty liver.