非酒精性脂肪肝病与胰岛素抵抗

Non-alcoholic fatty liver disease and insulin resistance

目的:就近年来国内外有关胰岛素抵抗在非酒精性脂肪肝病发病机制上的作用、以及与胰岛素抵抗相关的发病因素的研究进展,综述胰岛素抵抗与非酒精性脂肪肝病之间的关系。资料来源:应用计算机检索OVID和PUBMED2000-01/2005-11与氧应激、瘦素、脂联素、解偶联蛋白2、胰岛素抵抗和非酒精性脂肪肝病相关文章,检索词“Leptin,Adiponectin,Uncouplingprotein-2,insulinresistance,non-alcoholicfattyliver”,并限定文章语言种类为“English”。资料选择:就检索到的300余篇文献进行筛选,选择以氧应激、瘦素、脂联素、解偶联蛋白2、胰岛素抵抗和非酒精性脂肪肝病为主要研究内容的文献近20篇,无论观察对象为动物还是患者全部纳入,其中研究内容相似的,以近3年且发表在较权威杂志者优先,排除综述类文献。资料提炼:将筛选到的16篇文献按胰岛素抵抗和非酒精性脂肪肝的相互作用关系分类:其中1篇与非酒精性脂肪肝病与胰岛素抵抗具相关性有关,3篇与胰岛素抵抗和脂质代谢紊乱有相互作用相关,1篇与胰岛素抵抗和氧应激有相互作用相关,3篇与胰岛素抵抗和瘦素有相互作用相关,4篇与胰岛素抵抗和脂联素有相互作用相关,2篇与胰岛素抵抗和解偶联蛋白2有相互作用相关。资料综合:16篇文献共包括650例患者(或实验动物),从胰岛素抵抗与脂质代谢紊乱、胰岛素抵抗与氧应激反应和脂质过氧化、胰岛素抵抗与铁超载、胰岛素抵抗与瘦素、胰岛素抵抗与脂联素和胰岛素抵抗与解偶联蛋白2等方面说明了胰岛素抵抗对非酒精性脂肪肝病发病的作用,同时,其他与胰岛素抵抗的发生有相互作用的发病因素也影响着非酒精性脂肪肝病的发生发展。结论:非酒精性脂肪肝病的发生与胰岛素抵抗是并存的,与胰岛素抵抗具有相互作用的发病因素也与影响着非酒精性脂肪肝病的发病。

OBJECTIVE： To summarize the relationship between insulin resistance and non-alcoholic fatty liver by the mechanism of insulin resistance on effect of episode mechanism of non-alcoholic fatty liver as well as research development of onset factors related to insulin resistance at home and abroad. DATA SOURCES： Using the key terms of ＂Leptin, Adiponectin, Uncoupling protein-2, insulin resistance, non-alcoholic fatty liver＂, searched the OVId database and PUBMED database for the relevant articles about oxidative stress, leptin, adiponectin, uncoupling protein-2, insulin resistance, non-alcoholic fatty liver published from January 2000 to November 2005 in English. STUDY SELECTION： All about 300 articles were selected firstly, among which, nearly 20 articles on oxidative stress, leptin, adiponectin, uncoupling protein-2, insulin resistance and non-alcoholic fatty liver were selected from the almost searched 300 documents. No matter animals or patients were all included. Among the documents with similar content, the articles published in authoritative journals in the nearly 3 years were precedent. The reviews were excluded. DATA EXTRACTION： The 16 selected documents were classified according to the inter-relationships between insulin resistance and nonalcoholic fatty liver： 1 article was related to the association between nonalcoholic fatty liver and insulin resistance; 3 articles were associated with the relationship between insulin resistance and lipid metabolic disorder; 1 article was related to interaction between insulin resistance and oxidative stress; 3 articles were associated with the correlation between insulin resistance and leptin; 4 articles were associated with the relationship between insulin resistance and adiponectin; 2 articles were related to the interaction between insulin resistance and uncoupling protein -2. DATA SYNTHESIS： A total of 650 patients （or experimental animals） were included in 16 articles. The literatures explained that insulin resistance could influence the onset of the non-alcoholic fatty liver from the aspects between insulin resistance and lipid metabolic disorder, insulin resistance and oxidative stress and lipid peroxidation, insulin resistance and iron overloading, insulin resistance and leptin, insulin resistance and adiponeetin, insulin resistance and uncoupling protein-2 and so on. Meanwhile, other factors related to insulin resistance might affect the occurrence and development of non-alcoholic fatty liver. CONCLUSION： The occurrence of non-alcoholic fatty liver is accompanied with the insulin resistance. The episode factors related to the insulin resistance also influence the episode of non-alcoholic fatty liver.