非酒精性脂肪肝与血清瘦素和胰岛素抵抗关系

Association of serum leptin and insulin resistance with nonalcoholic fatty liver disease

目的探讨非酒精性脂肪肝(NAFLD)发病与患者血清瘦素水平、胰岛素抵抗指数、体重指数(BMI)及血脂紊乱的关系。方法对82例经肝穿活检诊断为NAFLD的患者分为轻、中、重三度,同时选择20例肝穿活检正常者为对照,检测血清瘦素、空腹血糖、空腹胰岛素水平及血脂,采用稳态模式评估法计算胰岛素抵抗指数,测量身高、体质量,计算BMI。结果NAFLD组与对照组之间血清瘦素水平、胰岛素抵抗指数、BMI及血脂紊乱比较有显著差异(P<0.05或0.01)。NAFLD患者随病变程度加重,血清瘦素水平和胰岛素抵抗指数有逐渐增高的趋势,且呈正相关关系。结论血清瘦素水平、胰岛素抵抗指数、BMI增高及血脂紊乱是NAFLD发病的危险因素,NAFLD病变程度与血清瘦素水平和胰岛素抵抗呈正相关。

Objective To investigate the relationship among serum leptin, homeostasis model assessment of insulin resistance （HOMA-IR）, body mass index （BMI） and dyslipidema in patients with nonalcoholic fatty liver disease （NAFLD）. Methods Eighty-two patients with NAFLD were divided into mild, moderate and severe NAFLD groups according histological examination results of the liver. Twenty healthy volunteers were chosen as the normal control （NC） group. Fasting insulin, glucose, leptin and lipid levels were measured in the 82 patients with NAFLD and the BMI calculated. IR index of the patients was calculated according to the HOMA method. Results Leptin, HOMA-IR index, BMI and dyslipidemia showed significant differences between NAFLD and NC groups （P〈0.05 or 0.01）. Leptin and HOMA-IR index increased with the exacerbation of NAFLD, both of which were positively correlated with the severity of NAFLD. Conclusion Increased leptin level, HOMA-IR, BMI and dyslipidemia can be important risk factors of NAFLD, and serum leptin level and HOMA-IR are positively correlated with the severity of NAFLD.