[瘦素和脂联素与非酒精性脂肪性肝病胰岛素抵抗的关系]

Li Yi-Ling, Yang Miao, Meng Xiao-Dan, He Xiao-Hu, Wang Bing-Yuan

Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.

Zhonghua Gan Zang Bing Za Zhi. 2010 Jun;18(6):459-62. doi: 10.3760/cma.j.issn.1007-3418.2010.06.015.

OBJECTIVES

To investigate the serum leptin and adiponectin levels in nonalcoholic fatty liver disease (NAFLD) patients, and their relationship with insulin resistance.

METHODS

A total of 120 cases were enrolled and divided into two groups: NAFLD group (n = 60) and normal control group (n = 60). The serum levels of leptin and adiponectin were measured by ELISA. The body mass index (BMI), waist-to-hip ratio (WHR), triglyceride (TG), total cholesterol (Tchol), high-density lipoprotein cholesterol (HDL-C) , aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), fasting blood glucose (FBG) and HOMA-IR (homeostasis model assessment insulin resistance) were detected and analyzed.

RESULTS

Compared with control group, the serum leptin level in NAFLD group was Significantly higher [(12.37+/-1.99) microg/L vs (5.20+/-1.03) microg/L, P less than 0.01], while the serum adiponectin level was significantly lower [(12.69+/-2.83) mg/L vs (22.83+/-4.61) mg/L, P less than 0.01]. HOMA-IR was also much higher in NAFLD group than that in control group[(4.86+/-0.63) vs (1.91+/-0.41), P less than 0.01]. Logistic regression analysis showed that leptin was positively correlated with WHR (beta value = 8.175, P less than 0.01), HOMA-IR (beta value = 0.974, P less than 0.01 ), FBG (beta value = 0.564, P less than 0.01 ). In contrast, adiponectin inversely associated with HOMA-IR (beta value = -0.495, P less than 0.01 ) and BMI (beta value = -0.314, P less than 0.01) respectively.

CONCLUSION

The increased serum leptin level and decreased serum adiponectin level in NAFLD patients independently associated with HOMA-IR.

目的

探讨非酒精性脂肪性肝病（NAFLD）患者血清瘦素和脂联素水平及其与胰岛素抵抗的关系。

方法

共纳入120例患者，分为两组：NAFLD组（n = 60）和正常对照组（n = 60）。采用酶联免疫吸附测定法（ELISA）检测血清瘦素和脂联素水平。检测并分析体重指数（BMI）、腰臀比（WHR）、甘油三酯（TG）、总胆固醇（Tchol）、高密度脂蛋白胆固醇（HDL-C）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、γ-谷氨酰转肽酶（GGT）、空腹血糖（FBG）及稳态模型评估胰岛素抵抗（HOMA-IR）。

结果

与对照组相比，NAFLD组血清瘦素水平显著升高[（12.37±1.99）μg/L对（5.20±1.03）μg/L，P<0.01]，而血清脂联素水平显著降低[（12.69±2.83）mg/L对（22.83±4.61）mg/L，P<0.01]。NAFLD组HOMA-IR也显著高于对照组[（4.86±0.63）对（1.91±0.41），P<0.01]。Logistic回归分析显示，瘦素与WHR（β值 = 8.175，P<0.01）、HOMA-IR（β值 = 0.974，P<0.01）、FBG（β值 = 0.564，P<0.01）呈正相关。相反，脂联素分别与HOMA-IR（β值 = -0.495，P<0.01）和BMI（β值 = -0.314，P<0.01）呈负相关。