Article(id=1198619423717294587, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198619422425448948, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.0289.2024.0301, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1678118400000, receivedDateStr=2023-03-07, revisedDate=null, revisedDateStr=null, acceptedDate=1687795200000, acceptedDateStr=2023-06-27, onlineDate=1763702739886, onlineDateStr=2025-11-21, pubDate=1716825600000, pubDateStr=2024-05-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763702739886, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763702739886, creator=13701087609, updateTime=1763702739886, updator=13701087609, issue=Issue{id=1198619422425448948, tenantId=1146029695717560320, journalId=1189873630562394117, year='2024', volume='49', issue='5', pageStart='489', pageEnd='610', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1763702739578, creator=13701087609, updateTime=1763702927730, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198620211667628088, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198619422425448948, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198620211667628089, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198619422425448948, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=527, endPage=533, ext={EN=ArticleExt(id=1198619424887505408, articleId=1198619423717294587, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Analysis of influencing factors of pancreatic fat deposition and the association with islet function in type 2 diabetes mellitus, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To analyze the influencing factors of pancreatic fat deposition in patients with type 2 diabetes mellitus (T2DM), and to explore the relationship between pancreatic fat deposition and islet function. Methods A survey on diabetes prevalence was conducted among 548 residents in the Nicheng community of Pudong New Area from October 2015 to December 2016, including 301 patients with T2DM and 247 subjects with normal glucose tolerance (NGT). General information of the subjects were recorded, blood biochemical and insulin indexes were measured, body composition was measured by dual-energy X-ray absorptiometry, and insulin resistance index (HOMA-IR) and islet cell sensitivity index (HOMA-β) were calculated. Fatty liver and pancreatic fat deposition were detected by ultrasound. Both the T2DM group and NGT group were further divided into two subgroups according to the pancreatic fat deposition. Differences in general demographic information, biochemical and body fat indices among the groups were compared. Multivariate logistic regression was used to analyze the influencing factors of pancreatic fat deposition. Results In the NGT group, the subgroup with pancreatic fat deposition showed higher levels of age, waist circumference, waist-to-hip ratio (WHR), body mass index (BMI), fasting insulin levels (FINS), 2-hour postprandial insulin levels (2 h INS), triglycerides (TG), uric acid (UA), alanine aminotransferase (ALT), fatty liver prevalence, abdominal fat percentage, and abdomen-to-hip ratio (AHR), compared with the subgroup without pancreatic fat deposition. High-density lipoprotein cholesterol (HDL-C) and limb fat percentage were lower in the subgroup with pancreatic fat deposition. In the T2DM group, the subgroup with pancreatic fat deposition showed higher levels of waist circumference, BMI, FINS, 2 h INS, TG, UA, ALT, aspartate aminotransferase (AST), fatty liver prevalence, and abdominal fat percentage, compared with the subgroup without pancreatic fat deposition, with statistically significant differences (P<0.05). The HOMA-IR and HOMA-β in both NGT and T2DM groups with pancreatic fat deposition were significantly higher than those in the groups without pancreatic fat deposition. The prevalence of insulin resistance also significantly increased, with statistically significant differences (P<0.05). The results of multivariate logistic regression analysis showed that HDL-C, HOMA-β, abdominal fat percentage, age and fatty liver were the influencing factors for pancreatic fat deposition in NGT. Conclusion Elderly individuals with abdominal obesity and fatty liver are more prone to developing pancreatic fat deposition, which can affect islet function and aggravate the insulin resistance.

, correspAuthors=Li Wei, authorNote=null, correspAuthorsNote=
E-mail:
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目的 分析2型糖尿病(T2DM)患者胰腺脂肪沉积的影响因素及其与胰岛功能的相关性。方法 2015年10月-2016年12月对浦东新区泥城镇某社区548名居民进行糖尿病患病情况调查,其中T2DM患者301例,正常糖代谢(NGT)者247名。记录受试者一般资料,测定血液生化、胰岛素指标,应用双能X线吸收法测定人体成分,计算胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)等。采用超声检测脂肪肝和胰腺脂肪沉积情况,以有无胰腺脂肪沉积将T2DM组及NGT组分别再分为两个亚组,比较各组一般资料、生化指标和体脂指标之间的差异。采用多因素logistic回归分析胰腺脂肪沉积的影响因素。结果 NGT组中,有胰腺脂肪沉积亚组的年龄、腰围、腰臀比(WHR)、体重指数(BMI),空腹胰岛素(FINS)、餐后2 h胰岛素(2h INS)、三酰甘油(TG)、血尿酸(UA)、谷丙转氨酶(ALT)水平,以及脂肪肝患病率、腹部脂肪百分比、腹臀比均高于无胰腺脂肪沉积亚组,高密度脂蛋白胆固醇(HDL-C)水平和四肢脂肪百分比均低于无胰腺脂肪沉积亚组(P<0.05或P<0.01);T2DM组中,有胰腺脂肪沉积亚组的腰围、BMI,FINS、2h INS、TG、UA、ALT、谷草转氨酶(AST)水平,以及脂肪肝患病率、腹部脂肪百分比均高于无胰腺脂肪沉积亚组(P<0.05)。NGT组与T2DM组有胰腺脂肪沉积亚组的HOMA-IR、HOMA-β和IR发生率均明显高于无胰腺脂肪沉积亚组(P<0.05)。多因素logistic回归分析显示,HDL-C、HOMA-β、腹部脂肪百分比、年龄和脂肪肝是NGT人群胰腺脂肪沉积的影响因素(P<0.05);脂肪肝和HOMA-IR是T2DM人群胰腺脂肪沉积的影响因素(P<0.001)。结论 高龄、腹型肥胖合并脂肪肝人群易发生胰腺脂肪沉积,后者可影响胰岛功能,加重胰岛素抵抗程度。

, correspAuthors=魏丽, authorNote=null, correspAuthorsNote=
魏丽,E-mail:
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花慧,硕士研究生,主要从事糖尿病的发病机制方面的研究

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花慧,硕士研究生,主要从事糖尿病的发病机制方面的研究

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Diabetologia, 2015, 58(7): 1646-1655., articleTitle=Pancreatic adipose tissue infiltration, parenchymal steatosis and beta cell function in humans, refAbstract=null)], funds=[Fund(id=1198619430403015447, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, awardId=PW2018D-14, language=EN, fundingSource=Health and Family Planning Technology Project of Pudong New Area(PW2018D-14), fundOrder=null, country=null), Fund(id=1198619430478512923, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, awardId=PW2018D-14, language=CN, fundingSource=浦东新区卫生计生科技项目(PW2018D-14), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1198619425663451667, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, xref=1, ext=[AuthorCompanyExt(id=1198619425671840276, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, companyId=1198619425663451667, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Biology, College of Fisheries and Life Science, Shanghai Ocean University, Shanghai 201306, China), AuthorCompanyExt(id=1198619425680228885, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, companyId=1198619425663451667, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1上海海洋大学水产与生命学院生物系,上海 201306)]), AuthorCompany(id=1198619425747337755, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, xref=2, ext=[AuthorCompanyExt(id=1198619425764114972, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, companyId=1198619425747337755, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Endocrinology and Metabolism, the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China), AuthorCompanyExt(id=1198619425772503581, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, companyId=1198619425747337755, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2上海交通大学附属第六人民医院内分泌代谢科,上海 200233)])], figs=[ArticleFig(id=1198619429547377377, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=EN, label=Tab.1, caption=

Comparison of clinical data between NGT and T2DM, and between subgroups with and without pancreatic fat deposition

, figureFileSmall=null, figureFileBig=null, tableContent=
指标 NGT组 T2DM组
无胰腺脂肪沉积(n=170) 有胰腺脂肪沉积(n=77) 合计(n=247) 无胰腺脂肪沉积(n=126) 有胰腺脂肪沉积(n=175) 合计(n=301)
男[例(%)] 66(38.8) 39(49.4) 104(42.1) 53(42.1) 73(41.7) 126(41.9)
年龄(岁, $\bar{x}±s$) 59.2±6.9 61.2±5.6(3) 59.9±6.6 63.1±6.3 63.5±6.1 63.3±6.1(2)
糖尿病病程[年, M(Q1, Q3)] - - - 3.0(1.5, 8.0) 4.5(2.0, 8.3) 4.0(2.0, 8.0)
腰围(cm, $\bar{x}±s$) 79.74±9.42 86.96±8.96(4) 82.05±9.85 84.84±10.22 88.67±10.31(4) 87.07±10.41(2)
WHR($\bar{x}±s$) 0.85±0.06 0.90±0.06(4) 0.87±0.07 0.88±0.06 0.89±0.06 0.89±0.06(2)
BMI(kg/m2, $\bar{x}±s$) 24.02±2.52 26.68±3.12(4) 24.85±2.98 25.45±3.09 27.70±3.23(4) 26.76±3.35(2)
FPG[mmol/L, M(Q1, Q3)] 5.41(5.12, 5.68) 5.41(5.15, 5.67) 5.41(5.13, 5.68) 7.47(6.48, 8.40) 7.42(6.63, 8.72) 7.44(6.58, 8.60)(2)
2hPG[mmol/L, M(Q1, Q3)] 6.22(5.56, 7.00) 6.56(5.70, 7.24) 6.32(5.57, 7.12) 12.62(11.38, 14.07) 13.16(11.52, 15.46) 13.00(11.41, 15.41)(2)
HbA1c[%, M(Q1, Q3)] 5.7(5.5, 5.9) 5.7(5.5, 5.9) 5.7(5.5, 5.9) 6.8(6.5, 7.7) 7.1(6.5, 7.9) 7.00(6.50, 7.85)(2)
FINS[μU/ml, M(Q1, Q3)] 6.08(4.15, 8.56) 7.23(8.52, 11.24)(4) 6.61(4.45, 9.24) 6.86(4.89, 10.79) 10.28(6.99, 15.83)(4) 8.81(5.96, 13.77)(2)
2h INS[μU/ml, M(Q1, Q3)] 29.88(19.37, 40.79) 35.00(26.44, 58.40)(4) 31.38(21.11, 43.06) 28.93(20.85, 45.87) 38.46(20.03, 67.30)(3) 34.19(21.54, 57.88)(1)
TC[mmol/L, M(Q1, Q3)] 5.00±0.84 4.99±0.84 4.99±0.84 5.10(4.29, 5.69) 5.12(4.59, 5.69) 5.14±0.98
TG[mmol/L, M(Q1, Q3)] 1.06(0.81, 1.50) 1.52(1.06, 2.08)(4) 1.21(0.88, 1.68) 1.45(1.02, 2.14) 1.68(1.30, 2.41)(4) 1.58(1.16, 2.35) (2)
HDL-C[mmol/L, M(Q1, Q3)] 1.40(1.19, 1.56) 1.17(1.03, 1.36)(4) 1.31(1.12, 1.50) 1.28(1.09, 1.43) 1.28(1.03, 1.44) 1.28(1.06, 1.44)(1)
LDL-C[mmol/L, $\bar{x}±s$] 3.47±0.68 3.55±0.66 3.49±0.68 3.63(3.00, 4.12) 3.60(3.18, 4.09) 3.61(3.09, 4.12)
BUN(mmol/L, $\bar{x}±s$) 5.27±1.23 5.51±1.09 5.36±1.19 5.60(4.70, 6.40) 5.50(4.60, 6.70) 5.50(4.60, 6.45)
Scr[μmol/L, M(Q1, Q3)] 64.00(57.00, 73.00) 65.50(58.00, 80.00) 65.50(57.00, 70.00) 63.00(55.00, 75.00) 64.00(55.00, 77.00) 63.00(55.00, 76.00)
UA[μmol/L, M(Q1, Q3)] 276.00(242.00, 318.00) 315.50(265.00, 356.00)(4) 289.50(249.50, 334.25) 303.00(257.00, 341.00) 317.00(260.50, 374.00)(3) 308.00(259.50, 350.50)(2)
ALT[U/L, M(Q1, Q3)] 18.00(14.00, 24.00) 22.00(17.00, 30.00)(4) 19.00(15.00, 25.75) 22.00(18.00, 27.00) 24.00(20.00, 32.00)(4) 23.00(17.00, 32.50)(2)
AST[U/L, M(Q1, Q3)] 23.00(20.00, 26.00) 24.00(21.00, 29.00) 23.00(20.00, 27.00) 22.00(15.00, 30.00) 25.00(19.00, 35.00)(4) 23.00(19.00, 30.00)
脂肪肝[例(%)] 36(21.2) 57(74.0)(4) 93(37.7) 65(51.6) 160(91.4)(4) 225(74.8)(2)
腹部脂肪百分比[%, M(Q1, Q3)] 39.4(23.4, 43.0) 46.2(39.7, 46.7)(4) 40.4(35.4, 44.1) 40.6(35.8, 45.0) 43.4(39.1, 47.2)(4) 42.4(37.5, 46.6)(2)
臀部脂肪百分比[%, M(Q1, Q3)] 34.7(27.6, 39.4) 34.1(28.4, 38.9) 34.5(27.9, 39.4) 32.5(27.1, 37.2) 33.8(29.2, 38.7) 33.5(28.2, 38.0)
腹臀比($\bar{x}±s$) 1.13±0.18 1.29±0.19(4) 1.18±0.20 1.26±0.17 1.30±0.17 1.28±0.17(2)
四肢脂肪百分比[%, M(Q1, Q3)] 35.4(26.2, 40.2) 33.5(27.3, 39.6)(3) 35.1(26.6, 40.0) 33.9(26.6, 38.5) 35.2(28.8, 40.2) 34.8(27.5, 39.8)
), ArticleFig(id=1198619429652234983, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=CN, label=表1, caption=

NGT组与T2DM组以及有无胰腺脂肪沉积亚组间的临床资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
指标 NGT组 T2DM组
无胰腺脂肪沉积(n=170) 有胰腺脂肪沉积(n=77) 合计(n=247) 无胰腺脂肪沉积(n=126) 有胰腺脂肪沉积(n=175) 合计(n=301)
男[例(%)] 66(38.8) 39(49.4) 104(42.1) 53(42.1) 73(41.7) 126(41.9)
年龄(岁, $\bar{x}±s$) 59.2±6.9 61.2±5.6(3) 59.9±6.6 63.1±6.3 63.5±6.1 63.3±6.1(2)
糖尿病病程[年, M(Q1, Q3)] - - - 3.0(1.5, 8.0) 4.5(2.0, 8.3) 4.0(2.0, 8.0)
腰围(cm, $\bar{x}±s$) 79.74±9.42 86.96±8.96(4) 82.05±9.85 84.84±10.22 88.67±10.31(4) 87.07±10.41(2)
WHR($\bar{x}±s$) 0.85±0.06 0.90±0.06(4) 0.87±0.07 0.88±0.06 0.89±0.06 0.89±0.06(2)
BMI(kg/m2, $\bar{x}±s$) 24.02±2.52 26.68±3.12(4) 24.85±2.98 25.45±3.09 27.70±3.23(4) 26.76±3.35(2)
FPG[mmol/L, M(Q1, Q3)] 5.41(5.12, 5.68) 5.41(5.15, 5.67) 5.41(5.13, 5.68) 7.47(6.48, 8.40) 7.42(6.63, 8.72) 7.44(6.58, 8.60)(2)
2hPG[mmol/L, M(Q1, Q3)] 6.22(5.56, 7.00) 6.56(5.70, 7.24) 6.32(5.57, 7.12) 12.62(11.38, 14.07) 13.16(11.52, 15.46) 13.00(11.41, 15.41)(2)
HbA1c[%, M(Q1, Q3)] 5.7(5.5, 5.9) 5.7(5.5, 5.9) 5.7(5.5, 5.9) 6.8(6.5, 7.7) 7.1(6.5, 7.9) 7.00(6.50, 7.85)(2)
FINS[μU/ml, M(Q1, Q3)] 6.08(4.15, 8.56) 7.23(8.52, 11.24)(4) 6.61(4.45, 9.24) 6.86(4.89, 10.79) 10.28(6.99, 15.83)(4) 8.81(5.96, 13.77)(2)
2h INS[μU/ml, M(Q1, Q3)] 29.88(19.37, 40.79) 35.00(26.44, 58.40)(4) 31.38(21.11, 43.06) 28.93(20.85, 45.87) 38.46(20.03, 67.30)(3) 34.19(21.54, 57.88)(1)
TC[mmol/L, M(Q1, Q3)] 5.00±0.84 4.99±0.84 4.99±0.84 5.10(4.29, 5.69) 5.12(4.59, 5.69) 5.14±0.98
TG[mmol/L, M(Q1, Q3)] 1.06(0.81, 1.50) 1.52(1.06, 2.08)(4) 1.21(0.88, 1.68) 1.45(1.02, 2.14) 1.68(1.30, 2.41)(4) 1.58(1.16, 2.35) (2)
HDL-C[mmol/L, M(Q1, Q3)] 1.40(1.19, 1.56) 1.17(1.03, 1.36)(4) 1.31(1.12, 1.50) 1.28(1.09, 1.43) 1.28(1.03, 1.44) 1.28(1.06, 1.44)(1)
LDL-C[mmol/L, $\bar{x}±s$] 3.47±0.68 3.55±0.66 3.49±0.68 3.63(3.00, 4.12) 3.60(3.18, 4.09) 3.61(3.09, 4.12)
BUN(mmol/L, $\bar{x}±s$) 5.27±1.23 5.51±1.09 5.36±1.19 5.60(4.70, 6.40) 5.50(4.60, 6.70) 5.50(4.60, 6.45)
Scr[μmol/L, M(Q1, Q3)] 64.00(57.00, 73.00) 65.50(58.00, 80.00) 65.50(57.00, 70.00) 63.00(55.00, 75.00) 64.00(55.00, 77.00) 63.00(55.00, 76.00)
UA[μmol/L, M(Q1, Q3)] 276.00(242.00, 318.00) 315.50(265.00, 356.00)(4) 289.50(249.50, 334.25) 303.00(257.00, 341.00) 317.00(260.50, 374.00)(3) 308.00(259.50, 350.50)(2)
ALT[U/L, M(Q1, Q3)] 18.00(14.00, 24.00) 22.00(17.00, 30.00)(4) 19.00(15.00, 25.75) 22.00(18.00, 27.00) 24.00(20.00, 32.00)(4) 23.00(17.00, 32.50)(2)
AST[U/L, M(Q1, Q3)] 23.00(20.00, 26.00) 24.00(21.00, 29.00) 23.00(20.00, 27.00) 22.00(15.00, 30.00) 25.00(19.00, 35.00)(4) 23.00(19.00, 30.00)
脂肪肝[例(%)] 36(21.2) 57(74.0)(4) 93(37.7) 65(51.6) 160(91.4)(4) 225(74.8)(2)
腹部脂肪百分比[%, M(Q1, Q3)] 39.4(23.4, 43.0) 46.2(39.7, 46.7)(4) 40.4(35.4, 44.1) 40.6(35.8, 45.0) 43.4(39.1, 47.2)(4) 42.4(37.5, 46.6)(2)
臀部脂肪百分比[%, M(Q1, Q3)] 34.7(27.6, 39.4) 34.1(28.4, 38.9) 34.5(27.9, 39.4) 32.5(27.1, 37.2) 33.8(29.2, 38.7) 33.5(28.2, 38.0)
腹臀比($\bar{x}±s$) 1.13±0.18 1.29±0.19(4) 1.18±0.20 1.26±0.17 1.30±0.17 1.28±0.17(2)
四肢脂肪百分比[%, M(Q1, Q3)] 35.4(26.2, 40.2) 33.5(27.3, 39.6)(3) 35.1(26.6, 40.0) 33.9(26.6, 38.5) 35.2(28.8, 40.2) 34.8(27.5, 39.8)
), ArticleFig(id=1198619429752898287, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=EN, label=Tab.2, caption=

Comparison of islet function indices between subgroups with and without pancreatic fat deposition in NGT or T2DM groups

, figureFileSmall=null, figureFileBig=null, tableContent=
指标 NGT组(n=247) T2DM组(n=301)

无胰腺脂肪沉积
(n=170)

有胰腺脂肪沉积
(n=77)

P

无胰腺脂肪沉积
(n=126)

有胰腺脂肪沉积
(n=175)

P
HOMA-IR[M(Q1, Q3)] 1.44(1.01, 2.08) 1.79(1.38, 2.76) <0.001 2.29(1.60, 3.62) 3.49(2.32, 5.57) <0.001
HOMA-β[M(Q1, Q3)] 64.42(42.86, 94.44) 76.69(58.34, 110.51) 0.001 39.95(23.79, 56.00) 50.11(33.19, 81.91) <0.001
), ArticleFig(id=1198619429853561589, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=CN, label=表2, caption=

NGT组与T2DM组有无胰腺脂肪沉积亚组间的胰岛功能指标比较

, figureFileSmall=null, figureFileBig=null, tableContent=
指标 NGT组(n=247) T2DM组(n=301)

无胰腺脂肪沉积
(n=170)

有胰腺脂肪沉积
(n=77)

P

无胰腺脂肪沉积
(n=126)

有胰腺脂肪沉积
(n=175)

P
HOMA-IR[M(Q1, Q3)] 1.44(1.01, 2.08) 1.79(1.38, 2.76) <0.001 2.29(1.60, 3.62) 3.49(2.32, 5.57) <0.001
HOMA-β[M(Q1, Q3)] 64.42(42.86, 94.44) 76.69(58.34, 110.51) 0.001 39.95(23.79, 56.00) 50.11(33.19, 81.91) <0.001
), ArticleFig(id=1198619429929059068, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=EN, label=Tab.3, caption=

Multivariate logistic regression analysis of factors associated with pancreatic fat deposition in NGT

, figureFileSmall=null, figureFileBig=null, tableContent=
变量 β P OR(95%CI)
HOMA-β -0.011 0.011 0.989(0.981~0.998)
HDL-C -2.569 <0.001 0.077(0.019~0.311)
腹部脂肪百分比 0.098 0.002 1.103(1.037~1.174)
年龄 0.064 0.018 1.063(1.011~1.124)
脂肪肝 2.024 <0.001 7.565(3.505~16.327)
), ArticleFig(id=1198619430038110979, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=CN, label=表3, caption=

NGT组中影响胰腺脂肪沉积的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量 β P OR(95%CI)
HOMA-β -0.011 0.011 0.989(0.981~0.998)
HDL-C -2.569 <0.001 0.077(0.019~0.311)
腹部脂肪百分比 0.098 0.002 1.103(1.037~1.174)
年龄 0.064 0.018 1.063(1.011~1.124)
脂肪肝 2.024 <0.001 7.565(3.505~16.327)
), ArticleFig(id=1198619430151357191, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=EN, label=Tab.4, caption=

Multivariate logistic regression analysis of factors associated with pancreatic fat deposition in T2DM

, figureFileSmall=null, figureFileBig=null, tableContent=
变量 β P OR(95%CI)
HOMA-IR 0.149 <0.001 1.161(1.070~1.260)
脂肪肝 2.467 <0.001 11.791(5.819~23.892)
), ArticleFig(id=1198619430272992013, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198619423717294587, language=CN, label=表4, caption=

T2DM组中影响胰腺脂肪沉积的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量 β P OR(95%CI)
HOMA-IR 0.149 <0.001 1.161(1.070~1.260)
脂肪肝 2.467 <0.001 11.791(5.819~23.892)
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2型糖尿病患者胰腺脂肪沉积的影响因素及其与胰岛功能的相关性分析
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花慧 1, 2 , 祝超瑜 2 , 肖元元 2 , 蒋伏松 2 , 高清歌 2 , 乔寄 2 , 魏丽 2, *
解放军医学杂志 | 临床研究 2024,49(5): 527-533
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解放军医学杂志 | 临床研究 2024, 49(5): 527-533
2型糖尿病患者胰腺脂肪沉积的影响因素及其与胰岛功能的相关性分析
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花慧1, 2, 祝超瑜2, 肖元元2, 蒋伏松2, 高清歌2, 乔寄2, 魏丽2, *
作者信息
  • 1上海海洋大学水产与生命学院生物系,上海 201306
  • 2上海交通大学附属第六人民医院内分泌代谢科,上海 200233
  • 花慧,硕士研究生,主要从事糖尿病的发病机制方面的研究

通讯作者:

魏丽,E-mail:
Analysis of influencing factors of pancreatic fat deposition and the association with islet function in type 2 diabetes mellitus
Hui Hua1, 2, Chao-Yu Zhu2, Yuan-Yuan Xiao2, Fu-Song Jiang2, Qing-Ge Gao2, Ji Qiao2, Li Wei2, *
Affiliations
  • 1Department of Biology, College of Fisheries and Life Science, Shanghai Ocean University, Shanghai 201306, China
  • 2Department of Endocrinology and Metabolism, the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
出版时间: 2024-05-28 doi: 10.11855/j.issn.0577-7402.0289.2024.0301
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目的 分析2型糖尿病(T2DM)患者胰腺脂肪沉积的影响因素及其与胰岛功能的相关性。方法 2015年10月-2016年12月对浦东新区泥城镇某社区548名居民进行糖尿病患病情况调查,其中T2DM患者301例,正常糖代谢(NGT)者247名。记录受试者一般资料,测定血液生化、胰岛素指标,应用双能X线吸收法测定人体成分,计算胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)等。采用超声检测脂肪肝和胰腺脂肪沉积情况,以有无胰腺脂肪沉积将T2DM组及NGT组分别再分为两个亚组,比较各组一般资料、生化指标和体脂指标之间的差异。采用多因素logistic回归分析胰腺脂肪沉积的影响因素。结果 NGT组中,有胰腺脂肪沉积亚组的年龄、腰围、腰臀比(WHR)、体重指数(BMI),空腹胰岛素(FINS)、餐后2 h胰岛素(2h INS)、三酰甘油(TG)、血尿酸(UA)、谷丙转氨酶(ALT)水平,以及脂肪肝患病率、腹部脂肪百分比、腹臀比均高于无胰腺脂肪沉积亚组,高密度脂蛋白胆固醇(HDL-C)水平和四肢脂肪百分比均低于无胰腺脂肪沉积亚组(P<0.05或P<0.01);T2DM组中,有胰腺脂肪沉积亚组的腰围、BMI,FINS、2h INS、TG、UA、ALT、谷草转氨酶(AST)水平,以及脂肪肝患病率、腹部脂肪百分比均高于无胰腺脂肪沉积亚组(P<0.05)。NGT组与T2DM组有胰腺脂肪沉积亚组的HOMA-IR、HOMA-β和IR发生率均明显高于无胰腺脂肪沉积亚组(P<0.05)。多因素logistic回归分析显示,HDL-C、HOMA-β、腹部脂肪百分比、年龄和脂肪肝是NGT人群胰腺脂肪沉积的影响因素(P<0.05);脂肪肝和HOMA-IR是T2DM人群胰腺脂肪沉积的影响因素(P<0.001)。结论 高龄、腹型肥胖合并脂肪肝人群易发生胰腺脂肪沉积,后者可影响胰岛功能,加重胰岛素抵抗程度。

胰腺脂肪沉积  /  糖尿病,2型  /  胰岛素抵抗

Objective To analyze the influencing factors of pancreatic fat deposition in patients with type 2 diabetes mellitus (T2DM), and to explore the relationship between pancreatic fat deposition and islet function. Methods A survey on diabetes prevalence was conducted among 548 residents in the Nicheng community of Pudong New Area from October 2015 to December 2016, including 301 patients with T2DM and 247 subjects with normal glucose tolerance (NGT). General information of the subjects were recorded, blood biochemical and insulin indexes were measured, body composition was measured by dual-energy X-ray absorptiometry, and insulin resistance index (HOMA-IR) and islet cell sensitivity index (HOMA-β) were calculated. Fatty liver and pancreatic fat deposition were detected by ultrasound. Both the T2DM group and NGT group were further divided into two subgroups according to the pancreatic fat deposition. Differences in general demographic information, biochemical and body fat indices among the groups were compared. Multivariate logistic regression was used to analyze the influencing factors of pancreatic fat deposition. Results In the NGT group, the subgroup with pancreatic fat deposition showed higher levels of age, waist circumference, waist-to-hip ratio (WHR), body mass index (BMI), fasting insulin levels (FINS), 2-hour postprandial insulin levels (2 h INS), triglycerides (TG), uric acid (UA), alanine aminotransferase (ALT), fatty liver prevalence, abdominal fat percentage, and abdomen-to-hip ratio (AHR), compared with the subgroup without pancreatic fat deposition. High-density lipoprotein cholesterol (HDL-C) and limb fat percentage were lower in the subgroup with pancreatic fat deposition. In the T2DM group, the subgroup with pancreatic fat deposition showed higher levels of waist circumference, BMI, FINS, 2 h INS, TG, UA, ALT, aspartate aminotransferase (AST), fatty liver prevalence, and abdominal fat percentage, compared with the subgroup without pancreatic fat deposition, with statistically significant differences (P<0.05). The HOMA-IR and HOMA-β in both NGT and T2DM groups with pancreatic fat deposition were significantly higher than those in the groups without pancreatic fat deposition. The prevalence of insulin resistance also significantly increased, with statistically significant differences (P<0.05). The results of multivariate logistic regression analysis showed that HDL-C, HOMA-β, abdominal fat percentage, age and fatty liver were the influencing factors for pancreatic fat deposition in NGT. Conclusion Elderly individuals with abdominal obesity and fatty liver are more prone to developing pancreatic fat deposition, which can affect islet function and aggravate the insulin resistance.

pancreatic fat deposition  /  diabetes mellitus, type 2  /  insulin resistance
花慧, 祝超瑜, 肖元元, 蒋伏松, 高清歌, 乔寄, 魏丽. 2型糖尿病患者胰腺脂肪沉积的影响因素及其与胰岛功能的相关性分析. 解放军医学杂志, 2024 , 49 (5) : 527 -533 . DOI: 10.11855/j.issn.0577-7402.0289.2024.0301
Hui Hua, Chao-Yu Zhu, Yuan-Yuan Xiao, Fu-Song Jiang, Qing-Ge Gao, Ji Qiao, Li Wei. Analysis of influencing factors of pancreatic fat deposition and the association with islet function in type 2 diabetes mellitus[J]. Medical Journal of Chinese People’s Liberation Army, 2024 , 49 (5) : 527 -533 . DOI: 10.11855/j.issn.0577-7402.0289.2024.0301
2型糖尿病(T2DM)的发病机制较复杂,包括胰岛素抵抗(IR)、胰岛素分泌不足和胰岛功能受损等因素的相互作用。除遗传、生活方式和肥胖等因素外,异位脂肪沉积也可能与糖尿病的发生发展有关[1-2],当能量摄入超过皮下白色脂肪组织的存储能力时,肝脏、胰腺、骨骼肌等组织或器官均可发生异位脂肪沉积[3-5]。有研究发现,胰腺脂肪沉积可能导致胰岛细胞损伤和凋亡,进而影响胰岛素的合成和释放,致使IR加重[6]。因此,了解胰腺脂肪沉积的影响因素及其与胰岛功能之间的关系,对深入理解T2DM的发病机制具有重要意义。然而,既往研究多关注肝脏脂肪沉积对糖尿病的影响,而胰腺脂肪沉积的相关报道相对较少。为此,本研究分析影响胰腺脂肪沉积的相关因素,并分别比较正常糖代谢(NGT)人群与T2DM人群中胰腺脂肪沉积对于胰岛β细胞功能的影响,旨在为T2DM的发病机制研究提供新的视角。
本研究为回顾性研究。2015年10月-2016年12月对浦东新区泥城镇某社区548名居民进行糖尿病患病情况调查,其中男233名(42.5%)、女315名(57.5%),年龄(61.8±6.6)岁。诊断标准:根据1999年世界卫生组织糖尿病诊断标准,血糖代谢正常为空腹血糖(FPG)<6.1 mmol/L且糖负荷后2 h血糖(2hPG)<7.8 mmol/L,而T2DM为FPG≥7.0 mmol/L和(或)2hPG≥11.1 mmol/L。纳入标准:(1)年龄40~75岁;(2)血糖代谢正常;(3)T2DM患者。排除标准:(1)胰腺炎、胰腺囊肿、胰腺癌相关胰腺病史;(2)酮症酸中毒、高渗性昏迷、感染等糖尿病急性并发症;(3)合并严重心、肝、肾及其他脏器功能不全;(4)资料收集不全。根据诊断标准将受试者分为NGT组(n=247)与T2DM组(n=301),NGT组研究对象均接受75 g口服葡萄糖耐量试验。再将T2DM组与NGT组分别依据胰腺超声结果分为有胰腺脂肪沉积亚组与无胰腺脂肪沉积亚组。本研究获上海交通大学附属第六人民医院东院伦理委员会审批(2016-004)。
记录受检者性别、年龄、身高、体重、腰围(腰部肋下缘与髂前上棘连线中点处周径)、臀围(臀部最大周径),计算体重指数[BMI;BMI=体重/身高2(kg/m2)]、腰臀比[WHR;WHR=腰围/臀围]。受试者禁食8 h后于清晨抽取空腹血和餐后2 h静脉血,采用葡萄糖氧化酶法检测血糖水平,应用全自动生化分析仪检测血脂和肝肾功能等,采用高效液相色谱法测定糖化血红蛋白(HbA1c)水平。采用电化学发光免疫分析法测定空腹胰岛素(FINS)和餐后2 h胰岛素(2h INS)水平,根据所测结果计算稳态模型评估胰岛素抵抗指数(HOMA-IR;HOMA-IR=FPG×FINS/22.5)和稳态模型评估胰岛β细胞功能指数[HOMA-β;HOMA-β=FINS×20/(FPG-3.5)],HOMA-IR≥2.69判断为患者存在IR[7]
所有受检者在室温状态下取平卧位,由上海交通大学附属第六人民医院经培训的同一医师采用美国Hologic公司的全身双能X线骨密度仪(型号:Discovery Wi)测量腹部总质量、腹部脂肪质量、臀部总质量和臀部脂肪质量,并计算腹部脂肪百分比[腹部脂肪百分比(%)=腹部脂肪质量/腹部总质量×100%]、臀部脂肪百分比[臀部脂肪百分比(%)=臀部脂肪质量/臀部总质量×100%]、四肢脂肪百分比[四肢脂肪百分比(%)=四肢脂肪质量/四肢总质量×100%]和腹臀比[腹臀比(%)=腹部脂肪质量/臀部脂肪质量×100%]。
由同一医师使用Philips iU Elite实时超声诊断仪进行腹部超声检查,凸阵探头频率3.5 MHz。受检者空腹12 h,取平卧位,常规扫查胰腺区域,观察胰腺形态、大小、边界及内部回声强度。胰腺回声与肾实质回声相似为0级,胰腺回声与腹直肌相等或较肝回声稍强为1级,胰腺回声高于腹直肌而低于腹后壁脂肪为2级,胰腺回声与腹后壁脂肪相等为3级,当胰腺出现1-3级时为胰腺脂肪沉积[8-9]。脂肪肝诊断依据:(1)肝区近场弥漫性高回声区,回声强度高于脾脏和肾脏;(2)远场回声衰退;(3)肝内管道结构显示不清;(4)肝脏轻中度肿大,肝前缘变钝[10]
采用SPSS 26.0软件进行统计分析。计量资料行Kolmogorov-Smirnov正态性检验,符合正态分布者以$\bar{x}±s$表示,两组间比较采用两独立样本t检验;不符合正态分布者以M(Q1Q3)表示,两组间比较采用Mann-Whitney U检验;计数资料以例(%)表示,组间比较采用χ2检验。胰腺脂肪沉积的影响因素以是否有胰腺脂肪沉积为因变量(0=无胰腺脂肪沉积;1=有胰腺脂肪沉积),NGT组以年龄、腰臀比、BMI、2h INS、HOMA-IR、HOMA-β、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、脂肪肝患病率和腹部脂肪百分比为自变量,T2DM组以腰围、BMI、2h INS、HOMA-IR、HOMA-β、TG、UA、ALT、AST、脂肪肝患病率和腹部脂肪百分比为自变量,分别进行多因素logistic回归分析。
P<0.05为差异有统计学意义。
NGT组中,男104名(42.1%),女143名(57.9%),年龄(59.9±6.6)岁,胰腺脂肪沉积患病率为31.2%;T2DM组中,男126例(41.9%),女175例(58.1%),年龄(63.3±6.1)岁,胰腺脂肪沉积患病率为58.1%,T2DM人群胰腺脂肪沉积患病率明显高于NGT人群(χ2=38.96,P<0.001)。两组患者在性别、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血尿氮素(BUN)、血肌酐(Scr)、AST、臀部脂肪百分比和四肢脂肪百分比方面,差异均无统计学意义(P>0.05)。
与NGT组比较,T2DM组年龄、腰围、WHR、BMI,FPG、2hPG、HbA1c、FINS、2h INS、TG、UA、ALT水平,以及脂肪肝患病率、腹部脂肪百分比和腹臀比明显增高,HDL-C水平明显降低,差异均有统计学意义(P<0.05或P<0.01)(表1)。
NGT组中,有胰腺脂肪沉积亚组的年龄、腰围、WHR、BMI,FINS、2h INS、TG、UA、ALT水平,以及脂肪肝患病率、腹部脂肪百分比和腹臀比明显高于无胰腺脂肪沉积亚组,HDL-C水平和四肢脂肪百分比明显低于无胰腺脂肪沉积亚组,差异均有统计学意义(P<0.05或P<0.01),而两个亚组间的性别,FPG、2hPG、HbA1c、TC、LDL-C、BUN、Scr、AST水平,以及臀部脂肪百分比差异均无统计学意义(P>0.05)。T2DM组中,有胰腺脂肪沉积亚组的腰围、BMI,FINS、2h INS、TG、UA、ALT、AST水平,以及脂肪肝患病率和腹部脂肪百分比明显高于无胰腺脂肪沉积亚组,差异有统计学意义(P<0.05或P<0.01),而两个亚组间的性别、年龄、糖尿病病程、WHR,FPG、2hPG、HbA1c、TC、HDL-C、LDL-C、BUN、Scr水平,以及臀部脂肪百分比、腹臀比和四肢脂肪百分比比较,差异无统计学意义(P>0.05)(表1)。
无论是NGT组还是T2DM组,与无胰腺脂肪沉积亚组比较,有胰腺脂肪沉积亚组的HOMA-IR、HOMA-β明显增高,差异有统计学意义(P<0.05,表2)。NGT组中,无胰腺脂肪沉积亚组存在IR患者19例(11.2%),有胰腺脂肪沉积亚组为20例(26.0%),有胰腺脂肪沉积亚组IR发生率明显高于无胰腺脂肪沉积亚组(χ2=8.727,P<0.003)。T2DM组中,无胰腺脂肪沉积亚组存在IR 52例(41.3%),有胰腺脂肪沉积亚组为119例(68.0%),有胰腺脂肪沉积亚组IR发生率明显高于无胰腺脂肪沉积亚组(χ2=20.734,P<0.001)。
多因素logistic回归分析结果显示,NGT组高龄(OR=1.063,95%CI 1.011~1.124,P=0.018)、合并脂肪肝(OR=7.565,95%CI 3.505~16.327,P<0.001)和较高的腹部脂肪百分比(OR=1.103,95%CI 1.037~1.174,P=0.002)是胰腺脂肪沉积的独立危险因素,高HOMA-β(OR=0.989,95%CI 0.981~0.998,P=0.011)和高HDL-C(OR=0.077,95%CI 0.019~0.311,P<0.001)是胰腺脂肪沉积的独立保护因素(表3)。T2DM组高HOMA-IR(OR=1.161,95%CI 1.070~1.260,P<0.001)和合并脂肪肝(OR=11.791,95%CI 5.819~23.892,P<0.001)是胰腺脂肪沉积的独立危险因素(表4)。
既往研究表明,胰腺脂肪沉积可对人类的健康造成多种危害,特别是与糖尿病的发生和发展相关[11]。因此,深入了解胰腺脂肪沉积的影响因素及其与胰岛功能的关系,从新的角度揭示糖尿病的发病机制,可为糖尿病的预防、诊断和治疗提供重要的科学依据。本研究主要分析了影响胰腺脂肪沉积的相关因素,并探讨了胰腺脂肪沉积与胰岛β细胞功能及IR之间的关系,结果显示,HDL-C、HOMA-β、腹部脂肪百分比、年龄和脂肪肝是NGT人群胰腺脂肪沉积的影响因素;脂肪肝和HOMA-IR是T2DM人群胰腺脂肪沉积的影响因素。无论在NGT组还是T2DM组中,胰腺脂肪沉积人群的IR水平和β细胞功能水平均明显高于无胰腺脂肪沉积人群,IR发生率也明显增高。
既往研究表明,胰腺脂肪沉积在普通人群中的患病率为16%~35%[12],而本研究发现胰腺脂肪沉积在NGT人群中的患病率(31.2%)相对较高,这与本研究所调查的人群年龄多集中于中老年有关。本研究还发现,NGT组有胰腺脂肪沉积人群的平均年龄高于无胰腺脂肪沉积人群,提示年龄是NGT人群胰腺脂肪沉积的独立危险因素。Murakami等[13]也发现,胰腺脂肪含量随着年龄增长而增加,这可能是由于随着年龄增长代谢水平降低所导致,也可能与老年人胰腺出现萎缩、纤维化等有关,胰腺纤维化后可引起胰腺实质回声增强[14]
本研究发现,在NGT组中HDL-C可对胰腺脂肪沉积起保护作用,即HDL-C水平升高可能有助于减少胰腺脂肪沉积的发生,这与胡竟成等[15]的研究结果一致。此外,Singh等[16]的Meta分析结果表明,胰腺脂肪含量与HDL-C水平呈负相关(r=-0.33,95%CI -0.35~-0.31)。此外,HDL-C水平与运动水平密切相关,因此可通过加强运动使HDL-C水平升高,从而预防胰腺脂肪沉积的发生。
本研究发现,两组胰腺脂肪沉积人群BMI均明显高于无胰腺脂肪沉积人群,NGT组胰腺脂肪沉积人群腰臀比也明显高于无胰腺脂肪沉积人群,且腹部脂肪百分比是NGT人群的独立危险因素,提示肥胖尤其是腹型肥胖与胰腺脂肪沉积密切相关。内脏脂肪组织可释放大量的炎性细胞因子,后者可通过抑制前脂肪细胞的分化,增加脂肪分解,减少脂肪存储,使血清游离脂肪酸水平升高,导致非脂肪组织中的脂肪沉积[12,17]。研究表明,肥胖小鼠的胰腺重量高于瘦鼠,且肥胖小鼠的小叶内脂肪和胰腺总脂肪明显增加[18]。不仅动物实验结果显示肥胖与胰腺脂肪沉积有关[19],也有多项临床试验[20-21]与本研究结果一致。此外,Jaghutriz等[22]发现,胰腺脂肪含量与BMI、全身脂肪含量和内脏脂肪含量呈正相关,且一项针对糖尿病前期患者的5年纵向随访研究表明,BMI升高可预测胰腺脂肪沉积的发生[23]
本研究发现,在两组人群中,有胰腺脂肪沉积人群的脂肪肝患病率、TG水平和ALT水平均明显高于无胰腺脂肪沉积人群。长期热量过剩可导致肝脏脂肪积累,且肝脏极低密度脂蛋白(VLDL)和TG的生成增加,并导致异位(如胰腺[24])脂肪的沉积。已有研究发现,肝脏脂肪增加可能是胰腺脂肪沉积的主要决定因素[25]。Lee等[26]对无糖尿病的正常人群进行分析后发现,ALT水平随胰腺脂肪沉积程度增加而升高。此外,张锦等[27]发现,对于高脂血症患者,血清ALT水平评估胰腺脂肪沉积严重程度的效能和敏感度均较高。
本研究采用HOMA-IR评价IR程度。既往有研究发现,胰腺脂肪含量增加与HOMA-IR呈正相关[28],与本研究结果一致。无论是NGT人群还是T2DM患者,有胰腺脂肪沉积亚组的HOMA-IR的整体水平均明显高于无胰腺脂肪沉积亚组,IR发生率也更高,尤其在T2DM组中,HOMA-IR是胰腺脂肪沉积发生的危险因素。肥胖和高胰岛素血症导致肝脏脂肪变性和VLDL浓度增高,脂肪异位沉积于胰腺中,在脂肪细胞因子和内分泌激素的作用下,脂肪分解增加,TG水平升高,肝游离脂肪酸释放增多,激活细胞受体分泌白细胞介素-1β和肿瘤坏死因子-α等炎性因子,这些炎性因子激活胰岛素靶细胞中的炎性信号,从而导致IR的发生[29-30]
本研究发现,HOMA-β是NGT人群发生胰腺脂肪沉积的保护因素。一些体外和动物研究表明,胰腺脂肪沉积与胰岛β细胞功能障碍之间存在联系[28,31]。胰岛素敏感性降低减弱了胰岛素对外周脂肪分解的抑制作用,使游离脂肪酸增加,促进了脂肪沉积。Quiclet等[32]采用新西兰肥胖(NZO)小鼠模型进行研究,发现胰腺中的脂肪积累与β细胞功能障碍有关,体外胰源性脂肪细胞培养胰岛的胰岛素分泌明显升高。一些临床研究表明,在糖耐量受损的个体中,胰腺脂肪含量与胰岛素分泌呈负相关,但在血糖正常或T2DM患者中不存在这种关系[33-35]。人类胰腺脂肪沉积与β细胞功能障碍之间的关系仍存在争议,这可能是由于胰腺脂肪沉积检测方法的不同及缺乏对胰腺脂肪沉积的评估标准导致了明显矛盾的结果。本研究则发现,胰腺脂肪沉积人群的HOMA-β水平高于非胰腺脂肪沉积人群,这可能与IR导致胰岛β细胞功能出现代偿性升高有关。
综上所述,本研究发现,高龄、腹型肥胖合并脂肪肝的人群更易发生胰腺脂肪沉积,胰腺脂肪沉积可影响胰岛功能,加重IR程度,长期IR可能会进一步发展为T2DM。通过干预胰腺脂肪沉积可能改善胰岛功能,减轻IR,从而达到治疗T2DM的效果。建议腹型肥胖合并脂肪肝的人群及早筛查胰腺脂肪沉积情况,早期检出胰腺异位沉积有助于T2DM的二级预防。积极干预如增加运动、降低体重尤其是减少腹部脂肪,可减少胰腺脂肪沉积。但本研究为单中心回顾性研究,结果可能存在一定偏倚,未来仍需要大规模纵向研究进一步验证相关结论。超声虽然是目前评估及诊断胰腺脂肪沉积的最常用手段,但其诊断结果可能受到医师的经验和主观判断以及患者的体型和胰腺位置的影响,且只能定性分析,因此未来研究可采用MRI衍生技术等,定量分析影响胰腺脂肪沉积的影响因素及其与胰岛功能的关系。
  • 浦东新区卫生计生科技项目(PW2018D-14)
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doi: 10.11855/j.issn.0577-7402.0289.2024.0301
  • 接收时间:2023-03-07
  • 首发时间:2025-11-21
  • 出版时间:2024-05-28
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  • 收稿日期:2023-03-07
  • 录用日期:2023-06-27
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Health and Family Planning Technology Project of Pudong New Area(PW2018D-14)
浦东新区卫生计生科技项目(PW2018D-14)
作者信息
    1上海海洋大学水产与生命学院生物系,上海 201306
    2上海交通大学附属第六人民医院内分泌代谢科,上海 200233

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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