超声E成像检查与胰岛素抵抗和IL-6在非酒精性脂肪性肝病中的相关性研究

The correlation between shear wave elastography and insulin resistance and IL-6 levels in patients with nonalcoholic fatty liver disease

目的通过研究超声E成像检查(shear wave elastography,SWE)与胰岛素抵抗(insulin resistance,IR)和炎性细胞因子白细胞介素-6(interleukin-6,IL-6)在非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者中的相关性,探讨SWE在NAFLD中的临床诊断意义。方法选取内分泌科收治的120例NAFLD患者为观察组,同时选取体检的50例健康志愿者为对照组,2组患者均检测血清肝功能指标:丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST);血脂指标:三酰甘油(triglycerid,TG)、总胆固醇(total cholesterol,TC);血清炎性细胞因子指标:IL-6;空腹血糖(fasting blood glucose,FPG);空腹胰岛素(fasting insulin,FINS)。采用稳态模型评价法计算胰岛素抵抗(HOMA-IR):HOMA-IR=空腹血糖×空腹胰岛素/22.5。采用超声E成像检查检测杨氏模量值,采用两样本t检验方法检测2组患者ALT、AST、TG、TC、FPG、FINS、HOMA-IR、IL-6水平,采用Pearson直线相关分析NAFLD患者杨氏模量值与HOMA-IR、IL-6相关性。结果观察组NAFLD患者ALT、AST、TG、TC、FPG、FINS、HOMA-IR、IL-6均高于对照组,差异均有统计学意义(P<0.05);观察组NAFLD患者SWE检查杨氏模量值高于对照组,差异均有统计学意义(P<0.05);直线相关分析发现,杨氏模量值与HOMA-IR、IL-6呈正相关(P<0.05)。结论NAFLD患者杨氏模量值高于对照组,且胰岛素抵抗指数HOMA-IR、炎性细胞因子IL-6呈正相关,提示NAFLD的发生可能与胰岛素抵抗有关,且SWE可作为临床NAFLD发生与发展的无创性诊断方法。

Objective To investigate the correlation between shear wave elastography(SWE)and insulin resistance(IR)and IL-6 levels in patients with nonalcoholic fatty liver disease(NAFLD),and to explore the clinical significance of SWE in diagnosis of NAFLD.Methods A total of 120 patients with NAFLD who were treated in our hospital were enrolled as observation group,at the same time,the other 50 healthy volunteers who underwent physical examination were enrolled as control group.The liver function indexes including alanine aminotransferase(ALT),aspartate aminotransferase(AST),and blood lipid indexes including triglycerid(TG),total cholesterol(TC),and serum levels of IL-6,and fasting blood glucose(FPG),fasting insulin(FINS)were detected.Moreover insulin resistance was evaluated by using homeostatic model(HOMA-IR),and HOMA-IR=fasting Blood sugar×fasting insulin/22.5.In addition SWE was used to detect Young’s modulus values,and independent sample t-test was used to detect the levels of ALT,AST,TG,TC,FPG,FINS,HOMA-IR and IL-6,and Pearson linear correlation was used to analyze the correlation between the Young’s modulus and HOMA-IR as well as IL-6.Results The levels of ALT,AST,TG,TC,FPG,FINS,HOMA-IR and IL-6 in observation group were significantly higher than those in control group(P<0.05).And the Young’s modulus values in observation group were significantly higher than those in control group(P<0.05).The linear correlation analysis showed that the Young’s modulus values were positively correlated with those of HOMA-IR,and IL-6(P<0.05).Conclusion The Young’s modulus values in patients with NAFLD are higher than those in healthy subjects,moreover,which are positively correlated with insulin resistance index HOMA-IR and inflammatory cytokine IL-6,suggesting that NAFLD may be related to IR,and SWE may be used as a non-invasive diagnostic method for the occurrence and development of NAFLD.