非酒精性脂肪性肝病与胰岛素抵抗关系及超敏C反应蛋白在其临床分型上作用

Relationship between NAFLD and IR and The Role of hs-CRP in Clinical Classification of NAFLD

目的探讨非酒精性脂肪性肝病(NAFLD)患者胰岛素抵抗(IR)的关系及超敏C反应蛋白(hs-CRP)水平对非酒精性单纯性脂肪肝(NAFL)和非酒精性脂肪性肝炎(NASH)的鉴别诊断作用。方法随机选择符合非酒精性脂肪性肝病临床诊断标准的NAFLD患者132例,按临床分型标准分为NAFL组82例,NASH组50例;同时选择50例健康人为对照组。分别观察三组空腹血糖(FPG)、空腹胰岛素(FINS)及hs-CRP水平,并采用稳态模式评估法(HOMA)计算胰岛素抵抗指数(HOMA-IR)。结果①FINS与HOMA-IR在对照组与二组NAFLD之间比较差异有统计学意义(P<0.01),NAFLD与HOMA-IR呈正相关关系。②NASH组hs-CRP比NAFL组高,两者比较差异有非常显著性意义(P<0.01)。结论①IR是NAFLD的独立危险因素,是非酒精性单纯脂肪肝的主要表现。②检测hs-CRP对非酒精性单纯脂肪肝和非酒精性脂肪性肝炎具有鉴别诊断的作用。

Objective To study the relationship between NAFLD and IR and the role of hs -CRP in the differential diagnosis between NAFL and NASH. Methods Total 132 NAFLD patients were selected randomly and divided into the NAFL group and the NASH group base on the clinical classification. There are 82 cases in the NAFL group and 50 cases in the NASH group. 50 healthy persons were selected as control group. FPG, FINS and hs - CRP of these three groups were measured. Homeostasis model assessment （HOMA） was applied to assess the status of the insulin resistance （ HO- MA - IR）. Results （1）The difference about the level of FINS and HOMA - IR between the control group and the two NAFLD groups was very significantly （P 〈 0. 01 ）. There has positive correlation between NAFLD and HOMA - IR （2）The level of hs - CRP in NASH group is higher than that of NAFL group. The difference between two groups was significantly （P 〈 0. 01 ）. Conclusion （1）IR is the independent risk factor of NAFLD and the main performance of NAFL. （2） Detecting the level of hs - CRP is an important role in the differential diagnosis between NAFL and NASH.