瘦素和雌激素在成年男性非酒精性脂肪肝病发病中的作用

Leptin and estrogen in pathogenesis of nonalcoholic fatty liver disease in male adults

目的:研究瘦素和雌激素在成年男性非酒精性脂肪肝病(NAFLD)发病中的作用. 方法:采用放射免疫法(RIA)测定体检人群中肥胖合并NAFLD患者(n=29)、单纯性肥胖者(n=29)和正常对照者(n=29)血清胰岛素、雌激素和瘦素水平,同时采用稳态模型法计算胰岛素抵抗指数(HOMA-IRI). 结果:空腹胰岛素水平和HOMA-IRI在对照组、肥胖组和NAFLD三组,依次升高,存在显著性差异(P<0.05); NAFLD组瘦素水平为9.55±3.56 mg/L与肥胖组的8.07±2.92 mg/L相比较,有升高的倾向(P=0.124),这两组均显著高于对照组5.17±3.29 mg/L(P<0.05);NAFLD组雌二醇为61.84±16.21 pg/L,显著高于对照组的51.45±12.31 pg/L (P<0.05).HOMA-IRI与瘦素显著正相关(r=0.604,P<0.001); 与雌二醇也呈显著正相关(r=0.241,P=0.02). 结论:NAFLD组的HOMA-IRI和空腹胰岛素水平高于肥胖组,肥胖组高于对照组,说明胰岛素抵抗是NAFLD患者基本特征;NAFLD患者瘦素和雌二醇水平升高,提示瘦素和雌激素可能参与了其胰岛素抵抗的发生发展.

AIM: To investigate the role of estrogen and leptin in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) in male adults. METHODS: Serum estradiol and leptin were measured by radioimmunoassay (RIA) in the following 3 groups of patients: obesity with NAFLD (n =29), obesity (n =29), and healthy control (n =29). RESULTS: Fasting insulin concentration and insulin resistance index calculated by homeostasis model assessment (HOMA-IRI) were the highest in NAFLD group while the lowest in control group (P<0.05). The levels of leptin in NAFLD group and obesity group were 9.55±3.56 mg/L, 8.07±2.92 mg/L, respectively, which were significantly higher than 5.17±3.29 mg/L in control group (P<0.05). Estradiol concentration in NAFLD group was 61.84±16.21 pg/L, higher than 51.45±12.31 pg/L in control group (P<0.05). HOMA-IRI was positively correlated with leptin (r =0.604, P<0.001) and estradiol (r =0.241, P=0.02). CONCLUSION: NAFLD is characterized with insulin resistance. Serum estradiol and leptin are higher in NAFLD group than those in the other two groups, and they may be involved in the pathogenesis of insulin resistance.