非酒精性脂肪肝与肥胖及胰岛素抵抗的关系

Obesity and insulin resistance in nonalcoholic fatty liver

探讨非酒精性脂肪肝 (NASH)的体脂含量和分布特征 ,血脂情况及与胰岛素抵抗的关系。对 87例观察对象分为NASH组 (30例 )和对照组 (5 7例 ) ,检测身高、体重、血脂、血糖、血胰岛素 ,计算胰鸟素敏感指数和体重指数 ;做腹部CT扫描以其配备软件计算腹内脂肪面积 (VA)和腹皮下脂肪面积 (SA)。 6 8例肥胖者发生NASH2 8人(41 18% ) ,19例体重正常者发生HASH2人 (10 5 3% )。 (x2 =6 175 ,P <0 0 2 5 )差异有显著性。不伴NASH的肥胖者VA(x±s,cm2 ) (男 :10 5 8± 2 9 6 女 :117 3± 33 1)与伴有NASH的肥胖者VA(男 :138 2± 5 3 7 女 :14 2 6± 31 2 )比较差异有显著性 (t =2 72 ,2 31 P <0 0 1,0 0 5 )。无NASH肥胖者与伴有NASH肥胖者比较IAI差异有显著性 (t =1 98 P <0 0 5 )。肥胖尤其是腹内型肥胖与NASH有密切的关系 ;肥胖者发生NASH ,胰岛素抵抗在其中起重要作用。

To study the relationship between nonalcoholic fatty liver(NASH),intra-abdominal obesity and insulin resistance Visceral adipose tissue areas(VA)and abdominal subcutaneous adipose areas(SA) were measured in 87 persons by using computed tomography(CT) weight(kg),high(m),serum glucose(FPG),lipid and insulin(FINS) were also measured Insulin action index(IAI,=-ln(FPG·FINS)) and body mass index (BMI,=kg/m 2) were calculated The subjects were cases with NASH (n=30),while the controls without NASH (n=57) Thirty casses of NASH among 87 cases were diagnosed by both CT and ultrasound scan The rates of NASH seemed to be higher in boese (41 18%) than in non-obese(10 53%, x 2=6 17, p <0 025) The VA( x ± s ,cm 2) of obese with NASH(male:138 2±53 7 femal:142 6±31 2)were significantly higher than that without NASH (male:105 8±29 6 femal:117 4±33 1 t =2 72,2 31 P <0 01,0 05 ) There was significant difference between obese with NASH and without NASH in IAI(t=1 98 P <0 05) NASH was associated with obesity,especially with intra-abdominal obesity Insulin resistance may play a role in the pathogenesis of NASH with fatty