非酒精性脂肪性肝病患者胰岛素抵抗与血清铁蛋白、γ-谷氨酰转肽酶的关系

Correlation of insulin resistance with serum ferritin and γ-glutamyl transferase in patients with non-alcoholic fatty liver disease

目的了解非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者胰岛素抵抗(insulin resistance,IR)与血清铁蛋白(serum ferritin,SF)及γ-谷氨酰转肽酶(γ-glutamyl transferase,GGT)的关系。方法选取108例NAFLD患者及80名健康体检者分别纳入NAFLD组及对照组。所有受试者分别检测体质量指数(BMI)、血压、血脂、ALT、AST、GGT、SF、空腹血糖(FPG)及空腹胰岛素(FINS)水平,稳态模型计算胰岛素抵抗指数(HOMA-IR)。结果 NAFLD组BMI、TG、LDL-c、GGT、SF、FINS、HOMA-IR均高于对照组(P<0.05),而HDL-c则低于对照组(P<0.05)。HOMA-IR与SF、GGT、LDL-c、BMI呈正相关(P<0.05),与HDL-c呈负相关(P<0.05)。多元逐步回归分析显示,SF、GGT、LDL-c及HDL-c是IR的主要危险因素(P<0.05)。结论 NAFLD患者血清SF、GGT及LDL-c水平升高而HDL-c水平下降,SF、GGT、LDL-c及HDL-c的变化是IR程度的主要影响因素。

Objective To investigate the correlation of insulin resistance （IR） with serum ferritin （SF） and γ-glu- tamyl transferase （GGT） in patients with non-alcoholic fatty liver disease （NAFLD）. Methods There were 108 pa- tients with NAFLD and 80 normal controls were selected. The levels of body mass index （BMI） , blood pressure, serum lipids, alanine transferase （ALT）, aspartate aminotransferase （AST）, GGT, SF, fasting plasma glucose （FPG）, fast- ing insulin （FINS） and homeostasis model assessment for insulin resistance （HOMA-IR） were measured in all subjects. Results The levels of BMI, TG, LDL-c, GGT, SF, FINS and HOMA-IR in NAFLD group were significantly higher than those in control group, but the level of HDL-c was lower in NAFLD group than that in control group （P 〈 0. 05）. The HOMA-IR was positively associated with SF, GGT, LDL-e and BMI, and was negatively associated with HDL-c （P 〈 0.05）. Multiple stepwise regression analysis showed that SF, GGT, LDL-c and HDL-c were main risk factors of IR. Conclusion The levels of serum SF, GGT, LDL-c and HDL-c are associated with IR in patients with NAFLD.