论文部分内容阅读
目的 探讨非酒精性脂肪肝炎(NASH)与脂代谢紊乱及胰岛素抵抗之间的关系。方法 对2 0 0 3年6～1 0月浙江大学医学院附属儿童医院收集的54例诊断为NASH的肥胖儿童及2 4例既无脂肪肝影像学改变也无肝转氨酶升高的单纯性肥胖儿童(对照组) ,进行血甘油三酯、胆固醇、空腹血糖/空腹血胰岛素比值(FGIR)的检测,分析NASH与高脂血症和胰岛素抵抗之间的关系。并对其中2 0例怀疑合并良性黑棘皮病的患儿行皮肤病理活检以确诊,分析NASH与良性黑棘皮病的关系。结果 54例NASH的患儿体重指数(BMI)为( 2 8 .1 0±4 .1 6) ,对照组BMI为( 2 3 . 91±1 . 88) ,二者相比,差异有显著性意义(t=5. 0 5,P <0 .0 1 )。NASH组中高脂血症及胰岛素抵抗(FGIR <7)的发生率分别为59. 2 6%和70 . 3 7% ,明显高于对照组(发生率为2 0 .83 % ,8 3 .3 % ,χ2 =9. 84,χ2 =2 5. 59,P <0 . 0 1 )。经相关分析,发现丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)与BMI、血胆固醇、血甘油三酯、FGIR呈显著相关(rs=0 . 41 3 ,0 . 2 9,0 . 3 79,-0 . 477,P <0 . 0 1 ;rs=0 . 3 590 3 4 .9,0 .3 4 8,-0 . 3 69,P <0. 0 1 )。且其中2 0例伴良性黑棘皮病(占3 7. 0 4% )。结论 NASH患儿存在严重的脂代谢紊乱及胰岛素抵抗。约1 /3以上NASH患儿合并良性?
Objective To investigate the relationship between nonalcoholic steatohepatitis (NASH) and lipid metabolism disorders and insulin resistance. Methods From June 2006 to October 2010, 54 obese children diagnosed as NASH and 24 non-fatal fatty liver imaging changes and simple obesity without hepatic transaminase were collected from Children’s Hospital of Zhejiang University School of Medicine. Children (control group), the triglyceride, cholesterol, fasting blood glucose / fasting insulin ratio (FGIR) were measured to analyze the relationship between NASH and hyperlipidemia and insulin resistance. Twenty cases of suspected patients with benign acanthosis nigricans were examined by skin biopsy to confirm the relationship between NASH and benign acanthosis nigricans. Results The body mass index (BMI) of 54 patients with NASH was (28.01 ± 4.16) and that of the control group (23.91 ± 1.88). There was a significant difference between the two groups Significance (t = 5. 0 5, P <0 .0 1). The incidences of hyperlipidemia and insulin resistance (FGIR <7) in NASH group were 59.26% and 70.37%, respectively, which were significantly higher than those in control group (the incidence was 20.83% and 8.33 %, χ2 = 9. 84, χ2 = 2 5. 59, P <0. Correlation analysis showed that ALT and AST were significantly correlated with BMI, blood cholesterol, triglycerides and FGIR (rs = 0.41 3,0.29,0 . 3 79, -0. 477, P <0. 0 1; rs = 0. 3 590 3 4 .9, 0. 34 48, -0 3 69, P <0 0 1). And 20 cases of benign acanthosis nigricans (accounting for 3.70.4%). Conclusion There are serious lipid metabolic disorders and insulin resistance in children with NASH. About 1/3 or more NASH children with benign?