非肥胖的高血压病患者的非酒精性脂肪肝与代谢综合征的关系

The relationship between metabolic syndrome and nonalcoholic fatty liver disease in non-obese hypertensive patients

目的探讨非肥胖的不伴有糖尿病的高血压病患者的非酒精性脂肪肝（NAFLD）与代谢综合征（MS）的关系。方法84例非肥胖的不伴有糖尿病的高血压病患者，根据B超诊断有无脂肪肝分为高血压伴NAFLD组42例，高血压不伴NAFLD组42例。对2组患者的体重指数（BMI）、血压、血糖、血脂、血胰岛素、胰岛素抵抗指数（HOMA-IR）、转氨酶及MS患病率等指标进行比较分析，并对MS与上述指标的关系进行多因素的logistic回归分析。结果高血压伴NAFLD组的BMI、甘油三酯、胰岛素、HO-MA-IR、转氨酶及MS患病率较不伴NAFLD组显著增高，而且MS与NAFLD呈独立相关。结论MS不但明显增加NAFLD发生率，而且还加重肝脏损害。

Objective To investigate the relationship between metabolic syndrome （MS） and nonalcoholic fatty liver disease （NAFLD） in non-obese and non-diabetic hypertensive patients. Method 84 non-obese and non-diabetic hypertensive patients were divided into 42 hypertensive patients with NAFLD and 42 hypertensive patients without NAFLD by abdominal uhrasonography examination. Body mass index （BMI）, blood pressure, fast and OGGT 2 hour plasma glucose, fast and OGGT 2 hour plasma insulin, plasma lipids and aminotransferase were measured in the two groups. Multivariate logistic regression analysis was used to identify the variables independently associated with MS. Result BMI, triglycerides, fast insulin,2 hour insulin, aminotransferase, HOMA-IR and MS prevalence rate in the group with NAFLD were significantly higher than these in the group without NAFLD. Multivariate logistic regression analysis （forward LR） showed NAFLD were independently associated with MS. Conclusion MS play a role not only in occurrence of NAFLD but also in liver injury.