非酒精性脂肪肝与代谢综合征的关系

目的探讨非酒精性脂肪肝(NAFL)脂代谢紊乱、胰岛素抵抗的情况及其与代谢综合征的关系.方法对284例NAFL患者测体重指数、血压、空腹血糖、胰岛素、肝功、血脂和血尿酸.以96例非脂肪肝的体检者为对照组.两组间年龄和性别构成差异无显著性.结果NAFL组体重指数、血压、空腹血糖、甘油三醋、总胆固醇、谷丙转氨酶和血尿酸水平显著高于对照组(P＜0.05);两组间总胆固醇和总胆红素差异无显著性(P＞0.05).NAFL组空腹血胰岛素、胰岛素抵抗指数(HOMA-IR)水平明显升高(P＜0.01).NAFL组合并肥胖、高血压、高甘油三酯血症和(或)低高密度脂蛋白胆固醇血症、高血糖和代谢综合征显著高于对照组(70.77%vs 20.83%、54.93% vs 29.17%、62.32%vs 21.88%、48.59% vs 15.63%、39.08% vs 8.33%).两组中119例有代谢综合征,其中有NAFL占93.28%,肥胖占88.23%,高血压占87.40%,血脂紊乱占92.44%,高血糖占65.55%.结论NAFL患者存在明显的代谢综合征各组分集聚的特征,代谢综合征患病率明显升高.因此NAFL是代谢综合征的一个危险因素.

The relationship between nonalcoholic fatty liver and metabolic syndrome

Objective:To investigate the disorder of lipid metabolism,degree of insulin resistance in patients of nonalcoholic fatty liver(NAFL) and relationship of NAFL with metabolic syndrome.Methods:In 284 patients with NAFL,we measured body mass index(BMI),blood pressure and fasting serum glucose,insulin,lipid,liver function and serum uric acid.Results were compared with a group of 96 controls which were matched in sex and age.Results:The results showed that BMI,blood pressure,fasting serum glucose,fasting serum insulin,serum triglycerides(TG),serum cholesterol(TC),aspartate aminotransferase and serum uric acid were significantly elevated in the groups of NAFL compared with those with fatty liver(P<0.05).But serum total cholesterol(TC) and total bilirubin were no significant differences(P>0.05).Serum insulin level and HOMA-IR were significantly more elevated in the groups of NAFL compared with those with fatty liver(P<0.01).Obesity,hypertension,hypertriglyceridemia and low high-density lipoproteins(HDL-C),hyperglycemia and metabolic syndrome were significantly higher in the groups of NAFL compared with those with fatty liver.Of 380 subjects,metabolic syndrome was found in 119,31.32%(119/380) of them.Out of the 119 patients,93.28% presented with NAFL,88.23% with obesity,87.40% with hypertension,92.44% with dyslipidaemia,65.55% with hyperglucose.Conclusion:This study confirmed that the different components of metabolic syndrome generally presented in patients with NAFL.The prevalence of metabolic syndrome was increased.So NAFL was a risk factor in patients of metabolic syndrome.