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目的:探讨非酒精性脂肪肝(NAFLD)血浆抵抗素水平与胰岛素抵抗的关系。方法:对福州总医院2007年6月至2008年4月32例NAFLD患者、29例脂肪肝并2型糖尿病患者和30例正常对照者,采用ELISA方法测定空腹血浆抵抗素,同时检测其身高、体重、腰围、臀围、血压、血糖、血脂、肝功能及胰岛素水平,并计算体重指数(BMI)、腰臀比(WHR)和胰岛素敏感指数(ISI)。结果:非酒精性脂肪肝组腰围、臀围、腰臀比、体重指数、空腹胰岛素(FINS)、丙氨酸氨基转移酶(ALT)、甘油三酯(TG)、低密度脂蛋白(LDL)、抵抗素水平均较正常对照组高,胰岛素敏感指数较对照组低,脂肪肝并2型糖尿病组胰岛素抵抗程度较非酒精性脂肪肝组更严重,抵抗素水平更高。相关分析显示血浆抵抗素与空腹胰岛素呈正相关(r=0.253,P=0.041),与胰岛素敏感指数呈负相关(r=-0.313,P=0.037),而与体重指数、腰臀比、血压、血脂、血糖无相关性。结论:非酒精性脂肪肝存在不同程度胰岛素抵抗,抵抗素水平升高;合并2型糖尿病者胰岛素抵抗更为严重,抵抗素水平更高。
Objective: To investigate the relationship between plasma resistin and insulin resistance in non-alcoholic fatty liver disease (NAFLD). Methods: Fasting plasma resistin was measured by ELISA in 32 patients with NAFLD from June 2007 to April 2008 in Fuzhou General Hospital, 29 patients with type 2 diabetes mellitus with fatty liver and 30 normal controls. The height, Body mass, waist circumference, hip circumference, blood pressure, blood glucose, blood lipids, liver function and insulin levels were measured. Body mass index (BMI), WHR and ISI were calculated. Results: The changes of waist circumference, hip circumference, waist-hip ratio, body mass index, fasting insulin (FINS), alanine aminotransferase (ALT), triglyceride (TG), low density lipoprotein (LDL) , Resistin levels were higher than the normal control group, insulin sensitivity index lower than the control group, fatty liver and type 2 diabetic patients with insulin resistance more severe than non-alcoholic fatty liver group, resistin levels higher. Correlation analysis showed that there was a positive correlation between plasma resistin and fasting insulin (r = 0.253, P = 0.041) and negative correlation with insulin sensitivity index (r = -0.313, P = 0.037) Blood lipids, blood glucose no correlation. Conclusion: There are different degrees of insulin resistance and higher levels of resistin in non-alcoholic fatty liver. Insulin resistance in type 2 diabetic patients is more serious and resistin levels are higher.