【摘要】 目的 研究2型糖尿病（type 2 diabetes mellitus，T2DM）合并非酒精性脂肪性肝病（non-alcoholic fatty liver disease， NAFLD）患者血漿脂肪細(xì)胞特異性脂肪酸結(jié)合蛋白（adipocyte-specific fatty acid-binding protein，A-FABP）的水平及其相關(guān)因素?！》椒ā?009年10月—2010年10月選取T2DM合并NAFLD組（A組）60例，未合并NAFLD組56例（B組）為研究對(duì)象。測(cè)定體質(zhì)量指數(shù)（body mass index，BMI），檢測(cè)血脂、糖化血紅蛋白（hemoglobin A1c，HbA1c）等生化指標(biāo)。放射免疫法測(cè)定空腹胰島素（fasting insulin，F(xiàn)INS），空腹C肽水平（fasting C-peptide，F(xiàn)CP），計(jì)算胰島素抵抗指數(shù)（homeostasis model of assessment-insulin resistance，HOMA-IR）、胰島素敏感指數(shù)（insulin sensitivity index，ISI），測(cè)定A-FABP、C反應(yīng)蛋白（C-reaction protein，CRP）及腫瘤壞死因子-α（tumor necrosis factor-α，TNF-α）。 結(jié)果 與B組患者相比，A組患者其血漿A-FABP水平、BMI、腰圍、腰臀比、丙氨酸氨基轉(zhuǎn)移酶、門(mén)冬氨酸氨基轉(zhuǎn)移酶、CRP、TNF-α、FCP、FINS、總膽固醇、甘油三酯、Ln（HOMA-IR）升高，Ln（ISI）降低，差異有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；兩組HbA1c差異無(wú)統(tǒng)計(jì)學(xué)意義（Pgt;0.05）。A-FABP水平變化與TNF-α、HOMA-IR、CRP呈正相關(guān)，與ISI呈負(fù)相關(guān)?！〗Y(jié)論 T2DM伴NAFLD中，A-FABP升高與胰島素抵抗是并存的，且存在明顯相關(guān)關(guān)系，二者在疾病的發(fā)生發(fā)展中均可能具有重要的作用?！続bstract】 Objective To analyze the serum level of adipocyte-specific fatty acid-binding protein (A-FABP) in patients with type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD), and its related factors. Methods From October 2009 to October 2010, 112 patients with T2DM were categorized into two groups: the group with NAFLD (group A) with 60 patients, and the group without NAFLD (group B) with 56 patients. Body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) were detected. Radioimmunoassay was carried out to measure fasting insulin (FINS) and fasting C-peptide (FCP), and homeostasis model of assessment-insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were calculated. At the same time, A-FABP, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α) were also detected. Results Compared with patients in group B, plasma levels of A-FABP, BMI, waistline, waist to hip ratio, ALT, AST, TG, TC, HDL-C, LDL-C, CRP, FCP, FINS, and HOMA-IR for patients in group A were all higher, while ISI was lower; and the differences in the above-mentioned parameters were statistically significant (Plt;0.05). The levels of HbA1c in the two groups were not significantly different (Pgt;0.05). The change of A-FABP level was positively correlated with TNF-α, HOMA-IR and CRP, while it wasnegatively correlated with ISI. Conclusions In patients with T2DM with NAFLD, there is an obvious correlation between the coexisting A-FABP rise and insulin resistance. Both of them played critical roles in the onset and developing of the disease.