Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Rio Hortega, University of Valladolid, Valladolid, Spain.
Eur Rev Med Pharmacol Sci. 2009 Nov-Dec;13(6):413-8.
Insulin resistance and adipocytokines have been associated with fat liver and non-alcoholic fat liver disease (NAFLD). The aim of this research was to study the influence of insulin resistance and adipocytokines in presurgical morbid obese patients on elevated serum alanine aminotransferase (ALT) as an indicator of NAFLD.
A population of 65 presurgical morbid obese patients was analyzed in a cross sectional study. HOMA-IR was calculated as indicator of insulin resistance. Adipocytokines (leptin, resistin, adiponectin, Interleukin-6 and TNF alpha) blood levels were measured.
Patients were classified as group I (n=33) when serum ALT activity was normal or group II (NAFLD patients; n=32) when serum ALT activity was greater than the median value of the group (> or =24 UI/L). In NAFLD group, BMI, weight, fat mass, waist to hip ratio, waist circumference, HOMA and insulin levels were higher than control group. Adiponectin levels were lower in group II than I. Anthropometric parameters were higher in both groups. In the multivariate analysis with dietary intake-, age- and sex-adjusted ALT concentration as a dependent variable, only HOMA remained as an independent predictor in the model (F=12.1; p<0.05). ALT concentration increased 0.48 UI/L (CI95%: 0.19-0.76) for each unit of HOMA increased.
Anthropometric parameters and insulin resistance are associated with elevated serum alanine aminotransferase in obese morbid patients with lower levels of adiponectin. However, in a multiple regression model only insulin resistance remained in the model.
胰岛素抵抗和脂肪细胞因子与脂肪肝和非酒精性脂肪性肝病（NAFLD）有关。本研究旨在研究胰岛素抵抗和脂肪细胞因子对术前病态肥胖患者血清丙氨酸氨基转移酶（ALT）升高（作为 NAFLD 指标）的影响。
对 65 例术前病态肥胖患者进行横断面研究。计算 HOMA-IR 作为胰岛素抵抗的指标。测量脂肪细胞因子（瘦素、抵抗素、脂联素、白细胞介素-6 和 TNF-α）的血液水平。
当血清 ALT 活性正常时，患者被分为组 I（n=33），当血清 ALT 活性大于组中位数时（>或=24 UI/L），患者被分为组 II（NAFLD 患者；n=32）。在 NAFLD 组中，BMI、体重、脂肪量、腰臀比、腰围、HOMA 和胰岛素水平均高于对照组。组 II 的脂联素水平低于组 I。两组的人体测量参数均较高。在多元分析中，以饮食摄入、年龄和性别调整后的 ALT 浓度为因变量，只有 HOMA 仍然是模型中的独立预测因子（F=12.1；p<0.05）。HOMA 每增加一个单位，ALT 浓度增加 0.48 UI/L（95%CI：0.19-0.76）。
在肥胖病态患者中，与 ALT 升高相关的是体脂参数和胰岛素抵抗，且这些患者的脂联素水平较低。然而，在多元回归模型中，只有胰岛素抵抗仍然存在于模型中。
