非酒精性脂肪肝患者血清脂联素水平变化的临床研究

Clinical study of the level of adiponectin in patients with nonalcoholic fatty liver disease

目的探讨非酒精性脂肪肝患者血清脂联素(APN)水平变化。方法选取非酒精性脂肪性肝病(NAFLD)患者115例,同期正常对照组96例,检测空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、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)、γ-谷氨酰转肽酶(GGT)、空腹血清胰岛素(FIN)、APN,稳态模型评估的胰岛素抵抗指数HOMA-IR。结果 NAFLD患者BMI、WHR、血清中的TG、LDL、ALT、GGT、FIN、HOMA-IR水平与对照组相比明显升高,差异有统计学意义(P<0.05);HDL-C、APN与对照组相比明显降低,差异有统计学意义(P<0.05);Pearson相关分析,APN与BMI、WRH、ALT、GGT、TG、FBG、HOMA-IR呈负相关性(r分别为-0.232、-0.310、-0.313、-0.368、-0.375、-0.231、-0.769,P<0.05),与HDL-C呈显著正相关性(r=0.324,P<0.05);多元Logistic逐步回归分析表明,WHR、BMI、HOMA-IR、APN是NAFLD的独立影响因素。结论 APN水平的降低与NAFLD的发生发展密切相关。

Objective To discuss changes in serum adiponectin levels in patients with nonalcoholic liver disease （NAFLD）. Methods 115 patients with nonalcoholic fatty liver disease were enrolled, and the fasting blood glucose （FBG） ,lipid profile,liver func- tion,fasting blood insulin（FIN） and adiponectin （APN） were measured. Homeostasis model assessment insulin resistance （HOMA- IR） were detected at the same time. 96 cases of health individuals were selected as control group. Results The BMI,WHR,TG,LDL, ALT, GGT, FIN, HOMA - IR level in NAFLD patients were significantly higher than those in the control group, but HDL - C and APN were lower （P 〈 0.05 ） ; Two variables linear correlation analysis showed that adiponectin was negatively correlated with BMI, WRH, ALT, GGT,TG,FBG and HOMA - IR （ P 〈 0. 05 ）, and positively correlated with HDL - C （ r = 0. 324, P 〈 0.05 ） ; Logistic analysis showed WHR, BMI, HOMA - IR and APN were the main effect factors of NAFLD. Conclusion APN is significantly correlated with in- cidence and development of NAFLD.