联合检测血清Leptin、INS、TNF-α、SOD对NAFLD的临床意义

Combined assay of serum Leptin,INS,TNF-α,SOD in diagnosis of nonalcoholic fatty liver disease

目的：探讨血清瘦素(Leptin),胰岛素(INS),胰岛素抵抗指数(IRI)．肿瘤坏死因子α(TNF-α),超氧化物岐化酶(SOD)浓度变化对NAFLD诊断及预后判断的临床应用价值。方法：采用放射免疫法检测Leptin、INS、TNF-α,化学法检测SOD,根据HOMA-IR-[FBG(mmol/l)×FIN(mIU/l)]/22．5计算胰岛素抵抗指数(IRI)。结果：①NASH组32例瘦素浓度(13．320±5．323ng/ml)显著高于NASFL组32例(8．068±2．320ng/ ml)(P＜0．05)和NC组32例(3．533±1．686ng/ml)(P＜0．05),NASFL组32例瘦素浓度显著高于NC组(P＜0．05)。②NASH组INS浓度(24．810±9．01 7mIU/l)及IRI(6．733±2．501)显著高于NC组(15．460±6．012mIU/l,4．131±2．158)(P＜0．05),NASFL组INS浓度(21．180±11．610mIU/l)及IRI(6．462±2．872)显著高于NC组(P＜0．05),NASH组INS浓度及IRI与NASFL组比较差异无显著性(P＞0．05)。③NASH组TNF-α浓度(0．322±0．165ng/ml)显著高于NC组(0．254±0．093ng/ml)(P＜0．05)．NASH组与NASFL组TNF-α浓度(0．271±0．098ng/ml)比较差异有显著性(P＜0．05),NASFL组与NC组TNF-α浓度比较差异无显著性(P＞0．05)。④NC组SOD浓度(112．200±7．978U/ml)显著高于NASH组(72．540±1．32U/ml)(P＜0．05),NASFL组SOD浓度(109．900±8．903U/ml)显著高于NASH组(P＜0．05),NASFL组与NC组SOD浓度比较差异无显著性(P＞0．05)。结论：联合检测血清Leptin、INS、TNF-α、SOD对NAFLD的诊断及预后判断具有一定的临床参考价值。

Objective:To evaluate the value of combined assay of serum Leptin,INS,IRI,TNF-α,SOD in the di- agnosis and prognosis of nonalcoholic fatty liver disease(NAFLD).Method:Chemical and radioimmunoassay meth- ods were used to determine the changes in levels of leptin,INS,TNF-αand SOD.Insalin resistance index (IRI) was calculated according to the formula of HOMA—IR=[FBG(mmol/l)×FIN(mIU/l)]/22.5.Results:①Ccom- pared with the normal control group(32cases)(3.533±1.686ng/ml),serum leptin levels were significantly ele vated(P＜0.05) in the nonalcoholic simple fatty liver (NASFL) group32cases) (8.068±2.320ng/ml) and the nonalcoholic steatohepatitis(NASH)group(32cases) (13.320±5.323ng/ml).Level of leptin was much higher in the NASH group than in the NASFL group(P＜0.05).②Serum insulin (INS) level was(24.810±9.017mIU/1, 6.733±2.501)in the NASFL group,and it was (21.180±11.610mIU/1,6.462±2.872)in NASFL group.Insulin resistance index(IRI) Was markedly higher compared with the normal control group(15.460±6.012mIU/1,4.131±2.158 P＜0.05),while no significant differences were observed in serum insulin (INS) level and insulin resist- ance index(IRI)between the NASH group and the NASFL group(P＞0.05).③Serum TNF-αwas much higher in the NASH group(0.322±0.165ng/ml)than in the normal control group(0.254±0.093ng/ml P＜0.05)and the NASFL group(0.271±0.098ng/ml).There were no obvious differences in serum TNF-αbetween the normal con- trol group and the NASFL group(P＞0.05).④Compared with the normal control group( 112.200±7.978U/ml), level of SOD was significantly lower(P＜0.05)in the NASH group(72.540±1.325U/ml).There was no signifi cant difference in serum SOD between the normal control group and the NASFL group (109.900±8.903U/ml,P＞0.05).Conclusion:Combined assay of serum leptin,INS,SOD,TNF-αis helpful in the diagnosis and prognosis of nonalcoholic fatty liver disease.