摘要
目的 探讨脂肪肝患者糖脂代谢紊乱及脂肪肝与胰岛素抵抗、肿瘤坏死因子 α(TNF α)水平之间的关系。方法 采用对照研究 ,脂肪肝组 3 5例 ,正常对照组 18例 ,检测两组患者血脂、血糖 (空腹和 2小时 )、胰岛素 (空腹和 2小时 )、肿瘤坏死因子 α(TNF α) ,采用稳态模式 (HOMA)评价胰岛素抵抗 ,并根据体重指数 (BMI)将脂肪肝患者分为非肥胖组 (BMI<2 5kg/m2 )和肥胖组 (BMI≥ 2 5kg/m2 ) ,进行分层分析。结果 肥胖与非肥胖脂肪肝组的空腹血糖 (FBG)和餐后 2小时血糖 (BG2h)、2小时胰岛素 (INS2h)、总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇(LDL C)、TNF α和胰岛素抵抗指数 (HOMA IR)均高于正常对照组 (均P <0 .0 5 )。脂肪肝肥胖组TG、HOMA IR水平高于非肥胖组 (均P <0 .0 5 )。Logistic回归分析显示 ,BG2h、TC、腰臀比 (WHR)是脂肪肝形成主要的危险因素。多元逐步回归分析结果显示 ,FBG、TG是脂肪肝患者胰岛素抵抗独立的危险因素。结论 脂肪肝患者无论是否肥胖都存在糖脂代谢紊乱、胰岛素抵抗 ,肥胖型脂肪肝患者更严重。降低血脂、减轻体重。
Objective To investigate disorder of glucose-lipid metabolism,insulin resistance in patients of fatty liver (F) and relationship between fatty liver and insulin resistance and level of tumor necrosis factor alpha(TNF-α).Methods The investigation uses case control study.Thirty-five patients of fatty liver and twenty-eight control subjects(C) were assayed for serum lipids,serum glucose(fasting and 2-hour postprandial),serum insulin(fasting and 2-hour postprandial) and serum tumour necrosis factor alpha(TNF-α).The patients of fatty liver were divided into obese and non-obese group according to diagnosis criteria.Homeostasis model assessment(HOMA) was applied for the status of insulin resistance.Results The result showed the level of fasting blood glucose(FBG),2-hour postprandial glucose(BG2h),2-hour postprandial insulin(INS2h),serum cholesterol(TC),serum triglyceride(TG),low density lipoprotein-cholesterol(LDL-C),tumor necrosis factor-α(TNF-α)and HOMA-IR were significantly increased in F of obese and non-obese compared with contol subjects(P< 0.05).The levels of serum triglyceride(TG) and HOMA-IR in obese fatty liver patients were significantly higher than non-obese group(P< 0.05).Logistic regression analysis showed that BG2h,TC and waist hip circumference rate(WHR) were the mainly risk factors of forming fatty liver.Multiple stepwise regression analysis showed that FBG and TG were the independent risk factors of insulin resistance in patients of fatty liver.Conclusion The present study confirms that disorder of glucose-lipid metabolism and insulin resistance were uniformly present in subjects of F,even in non-obese patients.Decreasing serum lipid,losing weight and reducing stack of interabdomen adipose tissue will benefit for decreasing liver steatosis.
出处
《临床荟萃》
CAS
北大核心
2003年第8期439-442,共4页
Clinical Focus
关键词
脂肪肝
胰岛素抵抗
肥胖
fatty liver
insulin resistance
obesity