脂肪肝患者A-FABP与胰岛素抵抗关系

Relationship between adipocyte fatty acid-binding protein and insulin resistance in patients with fatty liver

目的探讨非酒精性脂肪肝病(NAFLD)患者血清脂肪细胞型脂肪酸结合蛋白(A-FABP)与胰岛素抵抗(IR)的关系。方法选择NAFLD患者119例,正常对照120人,测量身高、体重、腰围、臀围、体质指数及腰臀比,检测血清中总胆固醇、甘油三酯、高密度脂蛋白胆固醇、空腹血糖、空腹胰岛素抵抗指数及脂肪细胞型脂肪酸结合蛋白,并进行对比分析。结果NAFLD组血清A-FABP水平(13.45±5.06),明显高于对照组(9.14±5.00)μg/L(P<0.01);且血清A-FABP水平与体质指数(BMI)、腰围(WC)、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、空腹胰岛素(FINS)、空腹血糖(FPG)及胰岛素抵抗指数(HOMA-IR)呈正相关(r依次分别为0.560,0.538,0.384,0.426,0.341,0.302,0.345,0.256,0.359,P均<0.01),而与HDL-C呈负相关(r=-0.337,P<0.001)。结论NAFLD患者存在胰岛素抵抗,且血清A-FABP水平与胰岛素抵抗密切相关。

Objective To study the relationship between adipocyte fatty acid-binding protein（A-FABP） and insulin resistance in patients with nonalcoholic fatty liver.Methods Overall 119 patients with nonalcoholic fatty liver and 120 normal controls were choosed.Hight,weight,waist circumference（WC）,hip circumference,body mass index（BMI）,waist-to-hip ratio（WHR）,triglyceride,total cholesterol（TG）,high density lipoprotein,fasting blood glucose（FBG）,fasting blood insulin（FINS）,homeostasis model assessment-insulin resistant index（NOMA-IR）,and adipocyte fatty acid-binding protein of the subjects were detected and compared.Results Compared with the control group,the lever of A-FABP increased（13.45±5.06 vs 9.14±5.00 μg/L,P0.01）.The level of A-FABP had positive correlations with BMI,WC,WHR,HOMA-IR,FINS,FBG,TG,systolic blood pressure and diastolic blood pressure（r=0.560,0.538,0.384,0.426,0.341,0.345,0.256,0.359,P0.01 for all）,and negative correlation with high density lipoprotein-C（r=-0.337,P0.01）.Conclusion Insulin resistance is present in patients with nonalcoholic fatty liver and correlates with the level of adipocyte fatty acid-binding protein.