T2DM合并NAFLD患者血清内脂素、体成分和ACR变化及其与发生大血管并发症的关系研究*

doi:10.3969/j.issn.1672-5069.2026.01.015

摘要/Abstract

摘要： 目的研究2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者血清内脂素、体成分和尿微量白蛋白/肌酐比值(ACR)变化及其与大血管并发症发生的关系。方法 2022年1月～2025年1月我院诊治的237例T2DM患者,其中合并NAFLD患者122例,使用人体成分分析仪检测腹部脂肪和内脏脂肪,估算内脏脂肪面积,常规检测尿微量白蛋白和肌酐,计算ACR,采用ELISA法检测血清内脂素。应用二元Logistic回归模型分析T2DM合并NAFLD患者发生大血管并发症的危险因素。结果合并NAFLD组血压、体质指数(BMI)和腰围均显著高于或大于T2DM(P<0.05);合并NAFLD组血清内脂素、腹部脂肪、内脏脂肪、内脏脂肪面积和ACR分别为(35.8±8.6)ng/mL、(8.9±2.3)kg、(2.9±0.8)kg、(91.8±20.6)cm²和(29.6±6.8)mg/g,均显著高于T2DM组【分别为(20.7±5.4)ng/mL、(7.1±1.4)kg、(2.2±0.7)kg、(64.5±12.4)cm²和(21.2±5.1)mg/g,P<0.05】;在本组122例T2DM合并NAFLD患者中发生大血管病变者31例(25.4%);发生大血管并发症组BMI、腰围、血清内脂素、腹部脂肪和ACR均显著大于未发生者(P<0.05);二元Logistic回归分析显示,BMI高(OR=3.108)、血清内脂素水平高(OR=4.187)和ACR高(OR=4.362)均是T2DM合并NAFLD患者发生大血管病变的危险因素(P＜0.05)。结论 T2DM合并NAFLD患者容易发生大血管病变,血清内脂素、体成分和ACR是危险因素。监测这些指标,可能有助于早期发现,并给予适当的检查和干预。

关键词: 非酒精性脂肪性肝病, 2型糖尿病, 内脂素, 体成分, 尿微量白蛋白/肌酐比值, 大血管病变

Abstract: Objective The aim of this study was to investigate serum visfatin, body composition and urinary albumin to creatinine ratio (ACR) changes in patients with type 2 diabetes mellitus (T2DM) and concomitant nonalcoholic fatty liver disease (NAFLD) and their relationship with the occurrence of macrovascular complications. Methods 237 patients with T2DM, of which including T2DM with concomitant NAFLD in 122 cases, were enrolled in our hospital between January 2022 and January 2025. Serum visfatin level was assayed by ELISA. Abdominal fat, visceral fat and visceral fat area were detected and calculated by body composition analyzer. Microalbuminuria and creatinine levels were routinely determined and ACR was calculated. Binary Logistic regression model was applied to analyze the risk factors of macrovascular disorders in patients with T2DM and NAFLD. Results Blood pressure, body mass index (BMI)and waist circumference (WC) in patients with T2DM and NAFLD were much greater or higher than in patients T2DM(P<0.05); serum visfatin, abdominal fat, visceral fat, visceral fat area and ACR in patients with T2DM and NAFLD were(35.8±8.6)ng/mL, (8.9±2.3)kg, (2.9±0.8)kg, (91.8±20.6)cm² and (29.6±6.8)mg/g, all significantly higher than [(20.7±5.4)ng/mL, (7.1±1.4)kg, (2.2±0.7)kg, (64.5±12.4)cm² and (21.2±5.1)mg/g, respectively, P<0.05] in patients with T2DM; of 122 patients with T2DM and NAFLD, macrovascular disorders was found in 31 cases (25.4%); BMI, WC, serum visfatin, abdominal fat and ACR in patients with macrovascular disorders were all significnalty higher than in those without(P<0.05); binary Logistic regression analysis showed that BMI(OR=3.108), serum visfatin (OR=4.187) and ACR (OR=4.362) were all the independent risk factors for occurrence of macrovascular disorders in patients with T2DM and NAFLD (P＜0.05). Conclusion Condition of patients with T2DM and NAFLD could be complicated by macrovascular disorders, and surveillance of serum visfatin, body composition and ACR might provide a hint for it.

Key words: Nonalcoholic fatty liver disease, Type 2 diabetes mellitus, Visfatin, Body composition, Urinary albumin to creatinine ratio, Macrovascular disorders

李蕾, 王欢欢, 宋利革, 冯培红, 康志强. T2DM合并NAFLD患者血清内脂素、体成分和ACR变化及其与发生大血管并发症的关系研究^*[J]. 实用肝脏病杂志, 2026, 29(1): 57-60.

Li Lei, Wang Huanhuan, Song Lige, et al. Serum visfatin, body composition and ACR changes in patients with type 2 diabetes mellitus and concomitant nonalcoholic fatty liver disease and their relationship with the occurrence of macrovascular complications[J]. Journal of Practical Hepatology, 2026, 29(1): 57-60.

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T2DM合并NAFLD患者血清内脂素、体成分和ACR变化及其与发生大血管并发症的关系研究^*

Serum visfatin, body composition and ACR changes in patients with type 2 diabetes mellitus and concomitant nonalcoholic fatty liver disease and their relationship with the occurrence of macrovascular complications

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