肥胖儿童非酒精性脂肪肝病与胰岛素抵抗的关系

Nonalcoholic Fatty Liver Disease and Insulin Resistance in Obese Children

目的探讨肥胖儿童非酒精性脂肪肝(NAFLD)与胰岛素抵抗之间的关系。方法采用对照研究,分别测量肥胖合并NAFLD(脂肪肝组)患儿和单纯肥胖不伴NAFLD(单纯肥胖组)患儿的身高、体质量,并检测两组患儿的血糖、血脂、尿酸水平。行口服葡萄糖耐试验和胰岛素释放试验,计算体质指数(BMI)和胰岛素抵抗指数(HOMA-IR)。结果两组患儿的BMI、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、尿酸、空腹血糖(FPG)、空腹胰岛素(FINS)、口服葡萄糖耐量试验2h血糖(2hPG)和2h胰岛素(2hFINS)及HOMA-IR间差别均有统计学意义(P<0.05)。结论肥胖儿童中合并NAFLD者存在严重的胰岛素抵抗和脂代谢异常,胰岛素抵抗可能是儿童NAFLD的发病机制之一。

Objective To investigate the relationship between nonalcoholic fatty liver disease （NAFLD） and insulin resistance in obese children. Methods The contractive study was taken to measure the height and weight of the body, and the levels of blood sugar, lipid and uric acid of the children patients in the NAFLD group and simple obese group. Oral glucose tolerance test and insulin releasing test were performed. The body mass index （BMI） and homeostasis model assessment - insulin resistance （HOMA -IR） were calculated. Results The BMI, total cholesterol （TC）, triglyceride （TG）, lower density lipoprotein - cholesterol （LDL - C） and uric acid of children in NAFLD group were obviously higher than those in simple obese group, while the value of 2 - h postprandial blood glucose （2h - PG） in oral glucose tolerance test and HOMA - IR were significantly elevated in the NAFLD compared with those in simple obese group （ P 〈 0. 05 ）. Conclusion The obese children complicated by NAFLD have a severe insulin resistance and an metabolite disturbance of serum lipid, and insulin resistance may be one of the significant pathogenesis for NAFLD.