高尿酸血症合并非酒精性脂肪性肝病患者颈动脉内膜中层厚度与脂联素的关系简

目的 以高尿酸血症合并非酒精性脂肪肝（NAFLD）患者为研究对象,了解该人群颈动脉内膜中层厚度（CIMT）,与血浆内炎性因子脂联素（APN）之间的关系及影响因素.方法 广东省深圳市盐田区盐港医院2011年1月～2012年12月体检人群中,按血尿酸水平及腹部B超检查情况分为：高尿酸血症并非酒精性脂肪肝病组60例（HUA＋NAFLD组）、单纯高尿酸血症组60例（HUA组）、健康对照组55例（对照组）.于空腹状态下,检测所有入组对象的血压（BP）、身高（Ht）、体重（Wt）、腹围（Wc）、臀围（Hc）及肝功能、肾功能、血糖（FPG）、血脂、胰岛素（Fins）、超敏C反应蛋白（hs-CRP）等实验室指标,并计算腰臀比（WHR）、体重指数（BMI）、胰岛素抵抗指数（HOMA-IR）等.用酶联免疫吸附法（ELISA）检测APN水平.使用德国SIEMENS彩色多普勒超声检测仪,检测所有入组人群的CIMT.结果 CIMT三组比较结果显示：HUA＋NAFLD组中CIMT为（0.97±0.35）mm,较对照组明显升高（P＜ 0.05或P＜0.01）.HUA＋NAFLD组8.40±1.85）mg/dL] APN与对照组（12.58±l.22）mg/dL]比较下降更明显（P＜0.01）.对CIMT、CRP、APN与年龄、血压、血脂、BMI、WHR、HOMA-IR、尿酸（UA）等进行直线相关分析,结果显示：CIMT与SBP、WHR、BMI、HOMA-IR、TC、TG、LDL-C、CRP、UA等指标呈正相关（P＜ 0.05或P＜ 0.01）;与HDL-C、APN呈负相关（P＜ 0.05或P＜ 0.01）.结论 合并非酒精性脂肪肝病的高尿酸血症者,较单纯高尿酸血症及正常对照人群更容易出现动脉硬化.

Relationship between carotid artery intima-media thickness and adiponectin in the patients with hyperuricemia and non-alcoholic fatty liver disease

Objective To investigate the situation of carotid artery intima-media thickness （CIMT） in hyperuricemia combined with non-alcoholic fatty liver disease （NAFLD） patients,and to explore the relationship between the level of adiponectin （APN） and CIMT.Methods The patients of physical examination in Yangang Hospital of Yantian District in Shenzhen City were divided into three groups based on the level of serum uric acid and ultrasound of liver.Hyperuricemia combined with non-alcoholic fatty liver disease （HUA＋NAFLD group,n =60）,simple hyperuricemia group （HUA group,n =60）,and normal group （control group,n =55）.The serum levels of fasting insulin,blood lipid,uric acid （UA）,APN,CRP and CIMT were detected.Waist-hip-ratio （WHR）,body mass index （BMI）,and homeostasis model assessment of insulin resistance （HOMA-IR） were calculated.Results The result of carotid artery thickness （CIMT） in HUA＋ NAFLD group was （0.97±0.35） mm,which was significantly higher than the control group （P 〈 0.05 or P 〈 0.01）.The value of APN in HUA＋NAFLD group （8.40±1.85）mg/dL] was much lower than that in control group （12.58±1.22） mg/dL]（P 〈 0.01）.CIMT,CRP,APN and age,blood pressure,blood fat,BMI,WHR,HOMA-IR,uric acid （UA） were taken straight line correlation,the results showed that CIMT had positive correlation with SBP,WHR,BMI,HOMA-IR,TC,TG,LDL-C,CRP,etc （P 〈 0.05 or P 〈 0.01）,but had negative correlation with HDL-C and APN （P 〈 0.05 or P 〈 0.01）.Conclusion There are more prone to atherosclerosis disease in the hyperuricemia with NAFLD than the simple hyperuricemia individuals.