Chen W, Yu Z, Li Y
The First Affilliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, China.
Zhonghua Gan Zang Bing Za Zhi. 2000 Apr;8(2):76-7.
To explore the correlation of nonalcoholic fatty liver (called "fatty liver" for short) and insulin resistance with abnormal glucose metabolism.
The subjects were 48 patients with fatty liver, while the controls were 15 normal persons. Oral glucose tolerance test (OGTT) and insulin release test were performed; and the area under curve of serum glucose (AUCSG), area under curve of insulin (AUCIns) and insulin sensitivity index (AUCSG/AUCIns) were calculated.
The insulin level in fatty liver group was significantly higher than that in normal control group at 60 min, 120 min and 180 min after glucose intake (P<0.01) with the postpond peak. The blood glucose level in the fatty liver group was significantly higher than that in normal control group at all time intervals except at 180 min after glucose intake (P<0.05). The AUCIns and AUCSG in the patient group were significantly higher than in the control group 209.56 vs 124.22, 24.72 vs 19.96, respectively (P<0.01). The insulin sensitivity index in the patient group was significantly lower than that in the control group (P<0. 05). There is no significant difference in the insulin sensitivity index between different degree of fatty liver (P>0.05).
It is evident that patients with fatty liver have insulin resistance with abnormal glucose metabolism, which is not related with the extent of fat infiltration in the liver, suggesting that insulin resistance with abnormal glucose metabolism is a very important contributor to the pathogenesis of fatty liver.
探讨非酒精性脂肪肝（以下简称“脂肪肝”）及胰岛素抵抗与糖代谢异常的相关性。
选取48例脂肪肝患者作为研究对象，以15例正常人为对照。进行口服葡萄糖耐量试验（OGTT）及胰岛素释放试验；计算血糖曲线下面积（AUCSG）、胰岛素曲线下面积（AUCIns）及胰岛素敏感指数（AUCSG/AUCIns）。
脂肪肝组在摄入葡萄糖后60分钟、120分钟及180分钟时胰岛素水平显著高于正常对照组（P<0.01），且峰值延迟。脂肪肝组在除摄入葡萄糖后180分钟外的所有时间点血糖水平均显著高于正常对照组（P<0.05）。患者组的AUCIns和AUCSG显著高于对照组，分别为209.56对124.22、24.72对19.96（P<0.01）。患者组的胰岛素敏感指数显著低于对照组（P<0.05）。不同程度脂肪肝之间的胰岛素敏感指数无显著差异（P>0.05）。
显然，脂肪肝患者存在胰岛素抵抗及糖代谢异常，且与肝脏脂肪浸润程度无关，提示胰岛素抵抗及糖代谢异常是脂肪肝发病机制的一个非常重要的因素。
