中青年男性非酒精性脂肪肝与胰岛素抵抗及血脂参数的相关分析

Correlation analysis of Insulin Resistance and Blood Lipids in Young and Middle-aged Men with Non-alcoholic Fatty Liver Disease

【目的】探讨中青年男性非酒精性脂肪肝（NAFLD）与胰岛素抵抗及血脂参数之间的关系，为制定正确干预措施提供依据。【方法】选取于本院体检中心进行健康体检的20～50岁糖耐量正常成年男性100例为研究对象。应用B超诊断脂肪肝，根据有无脂肪肝分为NAFLD组（62例）和正常对照组（38例）。测量人体基本参数和收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、空腹胰岛素（FINS）、血甘油三脂（TG）、胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、r-谷氨酰转肽酶（GGT）等相关指标，计算体重指数（BMI）和胰岛素抵抗指数（HOMA-IR）。【结果】NAFLD组SBP、DBP、BMI、腰围（WC）、GGT、TC、FINS、HOMA-IR水平均显著高于对照组（P〈0．01），HDL-C水平低于对照组（P〈0．01）。多因素logistic回归分析显示，SBP、DBP、BMI、WC、ALT、TG、TC、FINS和HOMA-IR均是NAFLD的高危因素，HDL-C是NAFLD的保护性因素。【结论】肥胖、脂代谢紊乱、高血压和胰岛素抵抗与NAFLD密切相关。

[Objective]To explore the correlation of insulin resistance and blood lipids in young and middle aged men with non-alcoholic fatty liver disease（NAFLD） in order to provide the basis for formulating correct intervention measures. [Methods] Adult men（aged 20～50 years old） with normal sugar tolerance in physical examination center of our hospital were enrolled as the study subjects. B-ultrasound was used for the diagnosis of fatty liver disease. According to with or without fatty liver disease, all subjects were divided into NAFLD group（ n =62） and normal control group（ n =38）. Anthropometric parameters and related indicators such as SBP, DBP, FPG, FINS, TG, TC, LDL-C, HDL-C, ALT, AST and GGT were measured. Body mass index （BMI） and insulin resistance index（HOMA-IR） were calculated. [Results] SBP, DBP, BMI, WC, GGT, TC, FINS and HOMA-IR in NAFLD group were significantly higher than those in control group（ P 〈0.01）, while HDL-C in NAFLD group was lower than that in control group（ P 〈0.01）. Multifactor logistic regres- sion analysis showed that SBP, DBP, BMI, WC, ALT, TG, TC, FINS and HOMA-IR were all the high-risk factors of NAFLD. HDL-C was the protect factor of NAFLD. [Conclusion] Obesity, lipid metabolism disor- der, hypertension and insulin resistance are closely related with NAFLD.