脂联素与非酒精性脂肪性肝病肝纤维化及胰岛素抵抗的关系

Serum adiponectin is related to liver fibrosis and insulin resistance in nonalcoholic fatty liver disease

目的研究脂联素水平与非酒精性脂肪性肝病(NAFLD)患者肝纤维化指标及胰岛素抵抗指数(HO-MA-IR)的关系。方法采用ELISA法检测NAFLD患者和正常对照组的脂联素水平及肝纤维化指标Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、Ⅳ型胶原(CⅣ)、层黏蛋白(LN)水平,采用稳态模式胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗。结果NAFLD组脂联素水平显著低于对照组,HOMA-IR及肝纤维化指标显著高于对照组(P<0.05)。IR与PCⅢ、PCⅣ、HA和LN呈显著正相关(P<0.05),脂联素水平与腰臀围比(WHR)、体重指数(BM I)、空腹血糖(FBG)、甘油三酯(TG)、空腹胰岛素(FINS)、HOMA-IR、PCⅢ、PCⅣ、HA和LN呈显著负相关(P<0.01或<0.05)。结论NAFLD患者血清脂联素水平降低,脂联素的表达在NAFLD患者肝纤维化与胰岛素抵抗进程中可能起重要作用。

Objective To investigate the relationship between the level of serum adiponectin and the indexes of liver fibrosis and insulin resistance （IR） in nonalcoholic fatty liver disease （NAFLD）. Methods ELISA was used to measure the serum levels of PC Ⅲ, PC Ⅳ, HA, LN and adiponectin, of which a comparative study was made between those in NAFLD patients and normal controls. IR was calculated by using homeostasis model assessment. Results The level of adiponectin was decreased （ P 〈 0. 05 ） , while the indexes of IR and liver fibrosis were significantly increased in NAFLD patients （ P 〈 0. 05 ）, compared with the controls. Positive correlation was found between IR index and serum levels of PCⅢ, PCⅣ, HA and LN （P 〈0.05） , while negative correlation was evident between serum adiponectin and the values of WHR, BMI, FBG, TG, FINS, HOMA- IR, PC Ⅲ, PC Ⅳ, HA and LN （P 〈0. 01 or P 〈0.05）. Conclusion The level of adiponectin is decreased in NAFLD patients, implying that the expression of adiponeetin may have important significance in the development of liver fibrosis and insulin resistance.