标题：2型糖尿病合并非酒精性脂肪性肝病患者中血镁与胰岛素抵抗的相关性

      作者：张文龙，叶鹏，魏东    成都市第二人民医院内分泌与代谢性疾病科，四川 成都 610021

      卷次： 2021年32卷12期

      【摘要】 目的 探讨2型糖尿病 (T2DM)合并非酒精性脂肪性肝病(NAFLD)患者中血镁与胰岛素抵抗的相关性。方法 回顾性分析2019年5~11月成都市第二人民医院住院部收治的60例初诊T2DM患者的临床资料，其中未合并NAFLD 30例作为单纯糖尿病组，合并NAFLD 30例作为NAFLD组。同时选取与之匹配的30例健康人群作为对照组。比较三组人群空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、体质量指数(BMI)、腰围(WC)、甘油三酯(TG)、胆固醇(TC)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、血镁等指标的差异。采用Pearson相关法分析NAFLD组各个指标与HOMA-IR的相关性。结果 单纯糖尿病组患者的FPG、BMI、WC、FINS、HbA1c、TC、AST、GGT明显高于对照组，血镁明显低于对照组，差异均有统计学意义(P<0.05)；NAFLD组患者的BMI、WC、FINS、TG、TC、ALT、AST、GGT明显高于单纯糖尿病组及对照组，血镁明显低于单纯糖尿病组及对照组，差异均有统计学意义 (P<0.05)；NAFLD组HOMA-IR与血镁呈负相关(r=-0.813，P<0.05)，与BMI、WC、FPG、FINS、TG、TC呈正相关(r=0.868、0.884、0.607、0.675、0.881、0.887，P<0.05)。结论 T2DM合并NAFLD患者中血镁明显低于正常人群及未合并NAFLD的T2DM人群，血镁与胰岛素抵抗密切相关，低镁血症可能参与了T2DM及NAFLD的发生、发展。
      【关键词】 2型糖尿病；非酒精性脂肪性肝病；血镁；胰岛素抵抗；相关性
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2021）12—1520—04

Correlation between serum magnesium and insulin resistance in type 2 diabetes complicated with non-alcoholicfatty liver disease.
ZHANG Wen-long, YE Peng, WEI Dong. Department of Endocrinology and Metabolism, ChengduSecond People's Hospital, Chengdu 610021, Sichuan, CHINA
【Abstract】 Objective To investigate the correlation between serum magnesium and insulin resistance (IR) intype 2 diabetes (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD). Methods The clinical data of 60inpatients with new-onset T2DM complicated with or without NAFLD, who admitted to Chengdu Second People's Hos-pital from May to November 2019, were retrospectively analyzed. The patients were equally divided into the T2DMgroup (n=30) and the NAFLD group (n=30). Meanwhile, 30 matched healthy people were recruited as the control group.Fasting plasma glucose (FPG), fasting insulin (FINS), insulin resistance index (HOMA-IR), glycosylated hemoglobin(HbA1c), body mass index (BMI), waist circumference (WC), triglyceride (TG), cholesterol (TC), alanine aminotransfer-ase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), serum magnesium of the threegroups were compared, and the relationships between HOMA-IR and each index were explored. Results Comparedwith the control group, FPG, BMI, WC, FINS, HbA1c, TC, AST, GGT were significantly increased and serum magne-sium were significantly decreased in the T2DM group, and the differences were statistically significant (all P<0.05).Compared with the T2DM group and the control group, FPG, BMI, WC, FINS, TG, TC, ALT, AST, GGT were signifi-cantly increased and serum magnesium were significantly decreased in the NAFLD group, and the differences were sta-tistically significant (all P<0.05). HOMA-IR in the NAFLD group was negatively correlated with serum magnesium(r=-0.813, P<0.05), and positively correlated with BMI, WC, FPG, FINS, TG, TC and BMI (r=0.868, 0.884, 0.607,0.675, 0.881, 0.887, P<0.05). Conclusion Serum magnesium in T2DM patients complicated with NAFLD is signifi-cantly lower than that in the normal population and those without NAFLD. Serum magnesium is closely related to IR.Hypomagnesemia may be involved in the occurrence and development of T2DM and NAFLD.
      【Key words】 Type 2 diabetes (T2DM); Non-alcoholic fatty liver disease (NAFLD); Serum magnesium; Insulinresistance (IR); Correlation