瘦素和胰岛素抵抗与儿童非酒精性脂肪肝的关系

目的 研究儿童非酒精性脂肪肝（NAFLD）患者血清瘦素（Leptin）和胰岛素抵抗（IR）的关系。方法 试验分两组：NAFLD组,79名诊断为NAFLD的儿童;对照组：79名健康儿童;检测患儿空腹血糖（FPG）、胰岛素（FINS）、Leptin和可溶性瘦素受体（sOB-R）,及肝肾功能和血脂变化,采用游离瘦素指数（FLI,Leptin /sOB-R）和Leptin评估Leptin水平,稳态模型胰岛素抵抗指数（HOMA-IR）和胰岛素敏感指数（ISI）评估IR。用多元逐步回归分析和偏相关分析对Leptin与IR指标的相关性进行分析。结果 NAFLD组血清BMI、FPG、FINS、HOMA-IR、Leptin、sOB-R和FLI均较对照组显著增高（P〈0.05）;在NAFLD患儿中,血清Leptin和FLI水平与FINS、HOMA-IR明显正相关（r1=0.632,P〈0.01,r2=0.386,P〈0.05）,与ISI呈明显负相关（r=-0.401,P〈0.05）;HOMA-IR和ISI与BMI相关（r1=0.260,P=0.033;r2=-0.358,P=0.003）;性别（0.410）、BMI（0.436）、年龄（0.321）、FINS（0.280）、ISI（-0.262）是NAFLD儿童血清Leptin或FLI水平的独立决定因素。

The relationship between leptin, insulin resistance with non-alcoholic fatty liver disease in children

Objective This study aims to evaluate the relationship between leptin, insulin resistance （Ia） and non-alcoholic fatty liver disease（NAFLD） in children. Methods All the chlidren random divided into NAFLD（diagnosed as NAFLD, n=79） and control （healthy children, n=79） groups, fasting glucose（FPG）, fasting insuline（FINS）, fasting leptin（Leptin） and its soluble receptor （sOB-R） were measured; free leptin index （FLI） was calculated as leptin/sOB-R; IR was estimated by homeostasis model assessment （HOMA-IR） and insulin sensitivity index （ISI）. Results The BMI. FPG. FINS. HOMA-IR. Leptin. sOB-R and FLI in children of NAFLD were significantly higher than control （P〈0.05）; HOMA-IR and ISI correlated with BMI（r1=0.260, P=0.033; r2=-0.358, P=0. 003; respectively）, Leptin correlated with gender（0.410）, BMI（0.436）, age （0.321）, FINS（0.280） and ISI（-0.262） in children of NAFLD. Conclusion The leptin and ISI in children of NAFLD were significantly improved, HOMA-IR and ISI correlated with BMI, and Leptin correlated with age, BMI, FINS, ISI and gender in NAFLD in children.