Objective To investigate the correlation of inflammation and oxidative stress with carotid artery intima-media thickness(IMT) in type-2 diabetes mellitus(type-2 DM) patients with nonalcoholic fatty liver disease(NAFLD). Methods 185 patients with type-2 DM were divided into two groups, DM with NAFLD group( n = 76 ) and DM without NAFLD group( n - 82 ). The levels of BMI, blood pressure, fasting plasma glucose (FPG) ,Hb AlC, fasting insulin (FINS) , serum lipids, aminopherase, serum in-terleukin-6( IL-6) ,hs-CRP,8-iso-PGF2α and carotid artery IMT were measured in all subjects. Results The levels of BMI,TG,TC,LDL-c,ALT,IL-6,8-iso-PGF2a,hs-CRP,insulin resistance index(HOMA-IR) and IMT in DM with NAFLD group were significantly higher than those in DM without NAFLD group(P < 0.05),whereas the level of HDL-C was otherwise(P <0.05). The carotid artery IMT was positively related with IL-6,8-iso-PGF2α,hs-CRP,HOMA-IR and LDL-C(P <0.05). A tstepwise multiple linear regression analysis showed that IL-6,8-iso-PGF2a and hs-CRP were major risk factors of carotid artery IMT. Conclusion NAFLD can increase the degree of inflammation and oxidative stress in patients with type-2 DM,which were major risk factors for atherosclerosis.%目的 了解2型糖尿病合并非酒精性脂肪性肝病患者体内炎症反应、氧化应激水平及其与颈动脉内膜中层厚度(IMT)的相关性.方法 选取2型糖尿病患者158例,按照是否合并非酒精性脂肪性肝病分为合并脂肪肝组(76例)和单纯糖尿病组(82例).检测体重指数(BMI)、血压、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、血脂、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白细胞介素(IL)-6、高敏C反应蛋白(hs-CRP)、8-异前列腺素F2α (8-iso-PGF2α)及颈动脉内膜中层厚度.结果 合并脂肪肝组患者BMI、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、IL-6、8-iso-PGF2α、hs-CRP、胰岛素抵抗指数(HOMA-IR)及IMT水平高于单纯糖尿病组,而HDL-C则低于单纯糖尿病组(P＜0.05).IMT与IL-6、8-iso-PGF2α、hs-CRP、HOMA-IR、LDL-C呈正相关(P＜0.01).多元逐步回归分析显示,IL-6、8-iso-PGF2α、hs-CRP是颈动脉IMT的主要危险因素.结论 非酒精性脂肪性肝病加重2型糖尿病患者炎症反应和氧化应激,炎症反应和氧化应激可能是动脉硬化的主要危险因素.
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