非酒精性脂肪性肝病患者血清瘦素与胰岛素抵抗的关系

The relationship between the serum leptin and insulin resistance in nonalcoholic fatty liver disease patients

目的通过检测非酒精性脂肪性肝病(NAFLD)患者血清瘦素(Lp)的水平,探讨血清瘦素与胰岛素抵抗的关系。方法应用RIA检测30例NAFLD患者及30例对照者血清Lp水平,并检测空腹血糖、总胆固醇、甘油三酯、C-肽、胰岛素、体质指数等临床指标,分析Lp与胰岛素抵抗、血脂及非酒精性脂肪性肝病的关系。结果 NAFLD患者的Lp、BMI、胰岛素及胰岛素抵抗指数(HOMAIR)均显著高于对照组(P<0.05)。男、女NAFLD患者Lp水平均高于男、女对照组(P<0.05)。以HOMAIR为因变量,Lp、BMI、C-肽、总胆固醇及甘油三酯作为自变量,进行多元逐步回归分析,瘦素为影响IR的主要因素。结论 Lp可促进胰岛素抵抗,提示Lp与NAFLD有密切的关系。

Objective To investigate the relationship between leptin and insulin resistance by detecting the changes in serum levels of leptin.Methods Blood samples were collected from 30 consecutive patients with liver biopsy-proven NAFLD and 30 persons with biopsy-proven normal liver as controls.Serum leptin levels was determined by RIA.Body mass index（BMI）was calculated for all subjects.Serum insulin,C-peptide and lipoprotein levels were also detected.Results Serum leptin level,BMI,insulin and HOMA IR in the NAFLD were significantly higher than controls（P0.05）.Both men and women in the NAFLD had higher serum leptin level than the men and women subjects of the controls（P0.05）.Multivariate analysis showed serum leptin level was independently related to HOMA IR.Conclusion Insulin resistance may be enhanced by leptin,it suggests leptin is closely associated with NAFLD.