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目的:探究血清脂肪细胞型脂肪酸结合蛋白（fatty acid binding protein，FABP4）及过氧化物酶体增殖物激活受体n γ（peroxisome proliferator-activated receptor n γ，PPARn γ）水平与代谢相关脂肪性肝病（metabolic-dysfunction associated fatty liver disease，MAFLD）合并2型糖尿病（type 2 diabetes mellitus，T2DM）的相关性。n 方法:选取张家口市第一医院2019年2月到2021年2月间收治的T2DM和MAFLD患者共230例，依据其疾病情况将患有T2DM且未合并MAFLD的患者80例，设为T2DM组；患有MAFLD且糖耐量正常患者78例，设为MAFLD组；MAFLD合并T2DM患者72例，设为MAFLD合并T2DM组。并选取同期健康志愿者100例作为对照组。观察上述受试者基线资料，测定肝酶水平、代谢相关指标、FABP4及PPARn γ水平。n 结果:T2DM组HOMA-IR和FABP4水平明显高于对照组（n P<0.05）；而HDL-C、CREA、PPARn γ水平明显低于对照组（n P<0.05）。MAFLD组BMI、AST、ALT、GGT、TG、HOMA-IR、FABP4水平明显高于对照组（n P<0.05）；而PPARγ水平明显低于对照组（n P<0.05）。T2DM合并MAFLD组患者BMI、AST、ALT、GGT、TG、HOMA-IR、FABP4明显高于未合并有MAFLD的T2DM组和对照组（n P<0.05）；而HDL-C、PPARn γ明显低于未合并有MAFLD的T2DM组和对照组（n P<0.05）。T2DM合并MAFLD组HOMA-IR、FABP4明显高于MAFLD组（n P<0.05）；而HDL-C、CREA、PPARn γ明显低于MAFLD组（n P<0.05）。FABP4与HOMA-IR、CREA呈正相关（均n P<0.05）；与HDL-C、PPARn γ呈负相关（均n P<0.05）。PPARn γ与TG、ALT呈正相关（均n P<0.05），与HOMA-IR呈负相关（n P<0.05）。ALT、TG、HOMA-IR、FABP4和PPARn γ等指标是T2DM患者发生MAFLD的独立影响因素（n P<0.05）。n 结论:FABP4与T2DM和MAFLD的发生呈正相关，PPARn γ与T2DM和MAFLD发生呈负相关，FABP4与PPARn γ的负反馈回路调节可引起胰岛素抵抗，从而增加T2DM合并MAFLD的发病风险，为疾病预防和诊治提供临床依据。n “,”Objective:To explore the correlation between serum adipocyte fatty acid binding protein 4 (FABP4) and peroxisome proliferator activated receptor gamma (PPAR gamma) levels and metabolism related fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) .Methods:230 patients with T2DM and MAFLD in Zhangjiakou First Hospital from Feb. 2019 to Feb. 2021 were selected. According to their disease conditions, 80 patients with T2DM and without MAFLD were set as simple T2DM group, 78 patients with MAFLD and normal glucose tolerance were set as simple MAFLD group, 72 patients with T2DM and MAFLD were set as T2DM and MAFLD group, and 100 healthy volunteers in the same period were selected as the control group.Results:The levels of HOMA-IR and FABP4 in T2DM patients were significantly higher than those in the control group (n P<0.05) , while the levels of HDL-C, crea and PPAR γ in T2DM grou were significantly lower than those in the control group (n P<0.05) . The levels of BMI, AST, alt, GGT, TG, HOMA-IR and FABP4 in MAFLD group were significantly higher than those in control group (n P<0.05) , while the level of PPAR γ in MAFLD group was significantly lower than that in control group (n P<0.05) . BMI, AST, alt, GGT, TG, HOMA-IR and FABP4 of T2DM patients with MAFLD were significantly higher than those of T2DM patients without MAFLD and control group (n P<0.05) , while HDL-C and PPAR γ were significantly lower than those of T2DM patients without MAFLD and control group (n P<0.05) . HOMA-IR and FABP4 in T2DM patients with MAFLD were significantly higher than those in MAFLD group (n P<0.05) , while HDL-C, crea and PPAR γ were significantly lower than those in MAFLD group (n P<0.05) . FABP4 was positively correlated with HOMA-IR and CREA (alln P<0.05) , and negatively correlated with HDL-Cand PPAR γ (alln P<0.05) . PPAR γ was positively correlated with TG and ALT (alln P<0.05) , and negatively correlated with HOMA-IR (n P<0.05) . Alt, TG, HOMA-IR, FABP4 and PPAR γ were independent risk factors for MAFLD in T2DM patients (n P<0.05) .n Conclusion:FABP4 is positively correlated with the occurrence of T2DM and MAFLD, PPAR γ is negatively correlated with the occurrence of T2DM and MAFLD, the negative feedback loop regulation of FABP4 and PPAR γ can cause the occurrence of insulin resistance, so as to improve the risk of T2DM combined with MAFLD, and provide clinical basis for clinical disease prevention and treatment.