非酒精性脂肪肝:代谢综合征的另一个特征

Non-alcohholic fatty liver:another feature of the metabolic syndrome

目的 分析非酒精性脂肪肝 (NAFL)临床及生化特征 ,以探讨NAFL可否成为代谢综合征的一个组成部分。方法 对 85例NAFL患者测体重指数、腰臀比、空腹血糖、血脂、胰岛素、餐后 2h血糖和胰岛素抵抗指数。以 43例非脂肪肝的体检者为对照组。结果 1.在NAFL患者中 ,中心性肥胖占 70 .5 9% ,高血压病占 3 1.77% ,高TG血症占 62 .3 5 % ,低HDL C占 3 6.47% ,均明显高于对照组 (P <0 .0 0 5～ 0 .0 1) ,而DM/IGT/IPG的患病率 ,两组相比无明显差异 ;2 .血清FINS水平和IR脂肪肝组也较对照组明显增加 (P <0 .0 1) ;3 .在 12 8例研究对象中 ,有 2 1例患者患有代谢综合征 ,其中脂肪肝者占 85 .71% ,中心性肥胖者占 90 .48% ,高血压者占 76.19% ,血脂紊乱者占 10 0 % ,DM/IGT/IPG者占 3 8.10 %。结论 NAFL患者存在明显的胰岛素抵抗 ,可作为代谢综合征的一个组成部分。

Objective In order to evaluate whether patients with non-alcoholic fatty liver(NAFL) presented common features with the metabolic syndrome, we investigated clinical and biochemical characteristics of NAFL.Methods In 85 patients with NAFL, we measured body mass index(BMI),waist/hip ratio,and fasting serum glucose,lipid,insulin and oral glucose tolerance and insulin resistance (IR) was calculated by Homa model. Results were compared with a group of 43 controls.Results 1. Central obesity was present in 70.59%, hypertension in 31.77%,hypertriglyceridemia in 62.35%, and low HDL-C in 36.47%,those markers were markedly elevated in all patients with fatty liver than persons in the control group(P<0.05～0.005);2.Serum insulin levels and IR were markedly elevated in the fatty liver group than in the control (P<0.005); 3.Of 128 subjects,metabolic syndrome was found in 16.41%(21/128) 0f them.Out of the 21 patients,85.71% presented with fatty liver, 90.48% with central obesity, 76.19% with hypertension, 100% with dyslipidaemia and 38.10% with DM/IGT/IPG. Conclusion Insulin resistance occur frequently in patients with NAFL and NAFL may be considered an additional feature of the metabolic syndrome.