非酒精性脂肪肝患者血清鸢尾素水平变化的研究

Changes of serum irisin level in patients with non-alcoholic fatty liver disease

目的探讨不同病变程度非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)患者血清鸢尾素(Irisin)水平的变化情况及Irisin与其他生化指标的相关性。方法选取135例NAFLD患者(轻度脂肪病变患者73例,中、重及极重度脂肪病变患者共62例)作为观察组,健康体检者150例为对照组,全自动生化分析仪测定其各项血脂指标水平及各项生化指标;酶联免疫吸附法测定血清Irisin水平;依据稳态模型评估法计算胰岛素抵抗指数,并同时测量身高、体质量等多项基线指标。结果血清Irisin水平与对照组相比,轻度NAFLD患者,中、重及极重度NAFLD患者均增高(P<0.05);其它各项指标与对照组相比,NAFLD组患者的BMI、TC、TG、AST、ALT、收缩压、舒张压、腰围、臀围、血糖、FINS及HOMA-IR均呈现不同程度升高,差异多有统计学意义(P<0.05);而年龄、性别、HDL-C、LDL-C水平差异多无统计学意义(P>0.05)。Spearman相关分析结果显示,研究对象血清Irisin水平与BMI(rs=0.168,P<0.05),FINS(rs=0.204,P<0.01),HOMA-IR(rs=0.205,P<0.05),AST(rs=0.149,P<0.05),腰围(rs=0.147,P<0.05)呈现正相关,而与TC(rs=-0.205,P<0.05),HDL-C(rs=-0.165,P<0.05)呈现负相关;FINS、HOMA-IR、AST是影响血浆Irisin水平的独立相关因素。结论血清Irisin水平在NAFLD组患者中较正常人群增高,且在轻度NAFLD患者中水平最高。

Objective To investigate the changes of serum irisin level and the relationship between serum irisin and other biochemical index in patients with non-alcoholic fatty liver disease.Methods One hundred and thirty five patients with non-alcoholic fatty liver disease （NAFLD）were selected from the Department of Hepatobiliary Surgery of Inner Mongolia Autonomous Region People＆#39;s Hospital （including 73 mild fatty liver patients and 62 moderate-to-severe-extremely severe fatty liver patients）as observation group,and 150 control subjects （NC）were selected from healthy people in medical centre as normal control group.Anthropometric indexes,the history of alcohol intake,lipid indexes level and the biochemical indicators,abdominal ultrasonographic findings,metabolic parameters,homeo-stasis model assessment-insulin resistance and serum irisin levels were measured in all subjects.The data were analyzed using student-t test,Spearman correlation analysis.Results Serum irisin levels were significantly increased in mild fatty liver and moderate-to-se-vere-extremely severe fatty liver patients compared with NC group （P＆lt;0.05）.Other clinical parameters were significantly increased in the observation group,including BMI,TC,TG,AST,ALT,systolic pressure,diastolic blood pressure,waist circumference,hip circumfer-ence,fasting blood glucose,FINS,HOMA-IR,compared with NC group （P〈0.05 ）.However,there were no significant differences in gender,HDL-C and LDL-C （P〉0.05）.Spearman correlation analysis showed serum irisin levels in observation group were positively associated with BMI （r=0.168,P〈0.05）,FINS（r=0.204,P〈0.01）,HOMA-IR（r=0.205,P〈0.05）,AST（r=0.149,P〈0.05）,waistline （r=0.147,P〈0.05）,but inversely associated with TC（r=-0.205,P〈0.05）,HDL-C（r=-0.165,P〈0.05）. FINS,HOMA-IR and AST were the independent factors associated with Irisin levels.Conclusion Serum irisin levels were significantly higher in NAFLD patients compared with NC group,which reached the highest in the mild fatty liver group.