晚期肝硬化患者血肿瘤坏死因子-α与胰岛素抵抗和胰岛素分泌功能的关系

Relationship of Plasma TNF-α to Insulin Resistance and Secretion Function in Advanced Liver Cirrhosis Patients

目的探讨晚期肝硬化患者血浆肿瘤坏死因子-α(TNF-α)与胰岛素抵抗和胰岛素分泌功能的相关性及晚期肝硬化患者糖代谢障碍的发生机制。方法检测40例晚期肝硬化患者和40例正常对照者血TNF-α、空腹血糖、空腹胰岛素、空腹乳酸水平,并计算稳态模式评估法胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-β)。结果晚期肝硬化患者血TNF-α、空腹血糖、空腹胰岛素、空腹乳酸和HOMA-IR均明显高于正常对照组(P<0.05),但HOMA-β明显低于正常对照组(P<0.05)。晚期肝硬化患者血浆TNF-α与空腹胰岛素、空腹血糖、空腹乳酸水平及HOMA-IR呈正相关(P<0.05),与HOMA-β呈负相关(P<0.05)。结论晚期肝硬化患者血浆TNF-α在胰岛素抵抗和胰岛素分泌功能下降及糖代谢障碍中可能发挥重要作用。

Objective To explore the relationship of plasma TNF-α to insulin resistance and excretion function, and the mechanism of glucose metabolism disorders in advanced liver cirrhosis （LC） patients. Methods The levels of TNF-α, fasting glucose, fasting insulin, fasting lactic acid were detected to calculate insulin resistance index （ HOMA - IR） and insulin secretion index （ HOMA -β） of homeostasis model assessment. Results The levels of TNF-α, fasting glucose, fasting insulin, fasting lactic acid and HOMA - IR were significantly higher in advanced LC patients than in normal controls （ P 〈 0.05）, but HOMA - β lower （P 〈 0. 05）. TNF -α were positively correlated with fasting glucose, fasting insulin, fasting lactic acid and HOMA - IR （ P 〈 0. 05 ）, but negatively with HOMA - β （ P 〈 0. 05 ）. Conclusion TNF -α may play an important role in reduction of insulin resistance and secretion function, and glucose metabolism disoreders.