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非酒精性脂肪性肝病与胰岛素抵抗的关联:非酒精性脂肪性肝病患者是否需要进行口服葡萄糖耐量试验?

Association of nonalcoholic fatty liver disease with insulin resistance: is OGTT indicated in nonalcoholic fatty liver disease?

作者信息

Sargin Mehmet, Uygur-Bayramiçli Oya, Sargin Haluk, Orbay Ekrem, Yayla Ali

机构信息

Department of Endocrinology-Diabetes, Kartal Education and Research Hospital, Istanbul, Turkey.

出版信息

J Clin Gastroenterol. 2003 Nov-Dec;37(5):399-402. doi: 10.1097/00004836-200311000-00010.

DOI:10.1097/00004836-200311000-00010
PMID:14564188
Abstract

Nonalcoholic fatty liver disease (NAFLD) is frequently associated with type 2 diabetes mellitus, obesity, and dyslipidemia. We tested the hypothesis that there may be an association between NAFLD and insulin resistance (IR); and its correlation with glucose tolerance status of subjects who aren't known patients with diabetes. One hundred and seventy-six consecutive patients with elevated serum aminotransferase levels and bright liver were evaluated. Sixty-two patients were excluded from the study. Age, gender, height, weight, body mass index, waist circumferences, and family history of diabetes were recorded. Fasting plasma glucose, insulin, lipid profile were measured. A standard oral glucose tolerance test (OGTT) was performed and the index of IR was calculated according to the HOMA method. Patients with a normal glucose tolerance formed group 1 (64 patients) and patients with impaired or diabetic glucose tolerance group 2 (50 patients). Age, female sex, family history of type 2 diabetes, fasting insulin, fasting plasma glucose and HOMA-R index were statistically significantly different between the groups. Although the subjects in the study are not known patients with diabetes, the prevalence of impaired or diabetic glucose tolerance was prominent. In conclusion, performing OGTT in cases with nonalcoholic fatty liver disease may be useful for early screening of diabetes mellitus.

摘要

非酒精性脂肪性肝病(NAFLD)常与2型糖尿病、肥胖症和血脂异常相关。我们检验了这样一个假设,即NAFLD与胰岛素抵抗(IR)之间可能存在关联;以及其与非糖尿病患者葡萄糖耐量状态的相关性。对176例血清转氨酶水平升高且肝脏回声增强的连续患者进行了评估。62例患者被排除在研究之外。记录了年龄、性别、身高、体重、体重指数、腰围和糖尿病家族史。测量了空腹血糖、胰岛素、血脂谱。进行了标准口服葡萄糖耐量试验(OGTT),并根据HOMA方法计算IR指数。葡萄糖耐量正常的患者形成第1组(64例患者),葡萄糖耐量受损或糖尿病患者形成第2组(50例患者)。两组之间的年龄、女性性别、2型糖尿病家族史、空腹胰岛素、空腹血糖和HOMA-R指数存在统计学显著差异。尽管该研究中的受试者并非已知的糖尿病患者,但葡萄糖耐量受损或糖尿病的患病率较高。总之,对非酒精性脂肪性肝病患者进行OGTT可能有助于早期筛查糖尿病。

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