2023 年第 3 期 第 18 卷

2型糖尿病患者血清共激活剂相关的精氨酸甲基转移酶1水平与非酒精性脂肪性肝病的相关性研究

Correlation between serum coactivator-associated arginine methyltransferase 1 level and non-alcoholic fatty liver disease in type 2 diabetes mellitus patients

作者：刘璐1王家浩1刘菊香2权金星2

英文作者：Liu Lu1 Wang Jiahao1 Liu Juxiang2 Quan Jinxing2

单位：1甘肃中医药大学第一临床医学院，兰州730000；2甘肃省人民医院内分泌科，兰州730000

英文单位：1The First Clinical College of Medicine Gansu University of Traditional Chinese Medicine Lanzhou 730000 China; 2Department of Endocrinology Gansu Provincial People′s Hospital Lanzhou 730000 China

关键词：2型糖尿病；非酒精性脂肪性肝病；共激活剂相关的精氨酸甲基转移酶1

英文关键词：Type2diabetesmellitus;Non-alcoholicfattyliverdisease;Coactivator-associatedargininemethyltransferase1

• 摘要：

• 目的 探讨2型糖尿病(T2DM）患者血清共激活剂相关的精氨酸甲基转移酶1（CARM1）水平与非酒精性脂肪性肝病（NAFLD）的相关性。方法 选取甘肃省人民医院内分泌科2020年12月至2021年12月收治的T2DM患者185例，将合并NAFLD的患者纳入NAFLD组（93例）、未合并的患者纳入非NAFLD组（92例）。另选取同期本院体检健康人群91例作为对照组。测定受试者血清CARM1、生化指标水平等。通过腹部超声定量分析测定NAFLD组患者肝脏脂肪含量（LFC）。分析T2DM患者血清CARM1水平与NAFLD的相关性。结果 对照组、非NAFLD组和NAFLD组血清CARM1水平比较差异有统计学意义［分别为（2.0±1.6）、（3.4±1.7）、（7.0±4.2）μg/L］（P<0.001）。多重线性逐步回归分析结果显示，总胆固醇是CARM1的独立影响因子（P＜0.001）。Pearson相关性分析结果显示，NAFLD组LFC与CARM1呈正相关（P<0.05）。卡方线性趋势检验结果显示，随着血清CARM1水平升高NAFLD患病率呈线性递增趋势（Z=70.070，P＜0.001）。二元Logistic回归分析结果显示，调整性别、年龄及其他相关因素后，血清CARM1水平与T2DM患者发生NAFLD相关，比值比=1.400，95%置信区间：1.185~1.653，P＜0.001；影响T2DM患者发生NAFLD的独立危险因素包括体重指数、三酰甘油、总胆固醇、CARM1。由体重指数、三酰甘油、总胆固醇和CARM1组成风险评估模型，Hosmer-Lemeshow检验结果表明预测模型的预测结果与实际NAFLD患病结果一致(P=0.693)。与ZJU指数（曲线下面积为0.858）相比，该模型（曲线下面积为0.955）对T2DM患者发生NAFLD风险具有良好的识别能力。结论 T2DM患者血清CARM1水平显著升高，且其水平与NAFLD相关。CARM1、体重指数、三酰甘油和总胆固醇组成的风险评估模型可用于评估T2DM患者发生NAFLD的风险。

• Objective  To explore the correlation between serum coactivator-associated arginine methyltransferase 1 (CARM1) level and non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients. Methods  From December 2020 to December 2021， 185 T2DM patients were enrolled from Department of Endocrinology, Gansu Provincial People′s Hospital. According to NAFLD, they were divided into NAFLD group (93 cases) and non-NAFLD group (92 cases). Another 91 health persons were enrolled as control group. The serum CARM1, biochemical index levels and other parameters were detected. The liver fat content (LFC) of the NAFLD group was measured by quantitative analysis of abdominal ultrasound. The correlation between serum CARM1 and NAFLD in T2DM patients was analyzed. Results  There was significant difference in serum CARM1 level among control group, non-NAFLD group and NAFLD group ［（2.0±1.6）, （3.4±1.7）, （7.0±4.2）μg/L, respectively］(P<0.001). Multilinear stepwise regression analysis showed that total cholesterol (TC) was an independent risk factor for CARM1 (P<0.001). Pearson correlation analysis showed that LFC was positively correlated with CARM1 in NAFLD group (P<0.05). Chi-square linear association showed that the prevalence of NAFLD tended to increase with serum CARM1 level increasing (Z=70.070，P＜0.001). Bivariate Logistic regression analysis showed that after adjusting for gender, age and other factors, serum CARM1 level was correlated with NAFLD in T2DM patients, odds ratio=1.400, 95% confidence interval: 1.185-1.653, P<0.001; body mass index (BMI), triacylglycerol (TG), TC and CARM1 were independent risk factors for NAFLD in T2DM patients. A risk assessment model was consisted of BMI, TG, TC, and CARM1, and Hosmer-Lemeshow test showed that the result of predictive model was consistent with the actual NAFLD prevalence (P=0.693). Compared with ZJU index (the area under the curve was 0.858), this model (the area under the curve was 0.955) had good indentification ability in the risk of T2DM patients developed NAFLD. Conclusions  The serum CARM1 level significantly increases in T2DM patients and the level is correlated with NAFLD. The risk assessment model consisting of BMI, TG, TC and CARM1 can be used to assess the risk of NAFLD in T2DM patients.