精神分裂症伴非酒精性脂肪肝患者血浆瘦素水平

Plasma Leptin in Schizophrenia with Non-Alcoholic Fatty Liver Disease

目的：探讨瘦素与精神分裂症患者非酒精性脂肪肝（ NAFLD ）的关系。方法35例精神分裂症伴NAFLD 患者（NAFLD组）测定血浆瘦素；同时测定体质量指数（BMI）、空腹血糖、血脂；以血清甘油三酯和血糖所得简易指数（TyG）评定IR、肝脏超声衰减系数评定NAFLD严重程度，并与35例不伴NAFLD的精神分裂症患者（对照组）进行对照。结果①NAFLD组患者BMI、TG、TC、TyG指数显著高于对照组（t＝2．074～8．482，P＝0．044～0．000），而HDL-C显著低于对照组（t＝2．367，P＝0．024）；②NAFLD组患者瘦素显著高于对照组（t＝7．112，P＝0．000），协方差分析调整影响因素后差异仍有显著性（F＝5．099， P＝0．026）；③NAFLD组患者肝脏超声衰减系数值显著高于对照组（t＝9．953，P＝0．000）；④NAFLD组肝脏超声衰减系数值与血浆瘦素水平正相关（r＝0．419，P＝0．017），偏相关分析调整影响因素后、二者仍正相关（r＝0．379，P＝0．038）。结论精神分裂症伴NAFLD患者血浆瘦素水平增高，可能与NAFLD的发生机制有关。

Objective To investigate the relationship between leptin and nonalcoholic fatty liver disease （ NAFLD） in schizophrenia patients.Methods Schizophrenia with or without NAFLD （NAFLD group,n=35;control group,n=35） were tested the level of plasma leptin,body mass index（BMI）,fasting plasma glucose （FPG） and lipids.Index derived from triglycerides and blood glucose （TyG in-dex）,and attenuation coefficient of liver ultrasonography were used for insulin resistance or NAFLD diagnosis and severity assessment re -spectively.Results Schizophrenia with NAFLD cases had significantly higher BMI ,TG,TC and TyG index （ t=2.074~8.482,P〈0.05）and lower HDL-C（t=2.367,P〈0.05）.The plasma level of leptin was significantly higher in NAFLD group than in control group （t=7.112,P〈0.001）.In an analysis of covariance,the difference was still significant after adjusted by influencing factor （F=5.099,P〈0.05）.The attenuation coefficient of liver was significantly higher in cases than in controls （t=9.953,P〈0.001）.There was a positive relationship between plasma level of leptin and attenuation coefficient of liver ,by both simple and partial correlation analysis adjusted by influence（r=0.418,0.379;P〈0.05）.Conclusion Leptin may related to the pathogenesis of NAFLD in patients with schizophrenia .