空腹血糖正常者非酒精性脂肪肝危险因素探讨

目的　探讨空腹血糖正常的非酒精性脂肪肝 (简称脂肪肝 )形成的危险因素。方法　引用 2 0 0 3- 11-0 1～ 2 0 0 3- 11- 30深圳某区探访病调查资料中空腹血糖 <5 . 6mmol/L的脂肪肝患者 15 8例和正常对照 316名参加本研究 ,采用McAuley指数、稳态模式法胰岛素抵抗指数 (HOMA -IR)和空腹胰岛素 (FINS)评价胰岛素抵抗。结果　控制年龄和性别后与对照组比较 ,脂肪肝组体重指数、腰围、腰臀比、全身脂肪百分比、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、甘油三酯、HOMA -IR和FINS升高 (均为P <0 . 0 0 1) ,而高密度脂蛋白胆固醇和McAuley指数降低 (均为P <0 .0 0 1) ;Logistic回归分析显示 ,体重指数、腰围和McAuley指数是脂肪肝形成的独立危险因素。结论　空腹血糖正常者脂肪肝形成的独立危险因素是肥胖和胰岛素抵抗。

Study of risk factors of nonalcoholic fatty liver disease in subjects with normal fasting plasma glucose

Objective To investigate risk factors of nonalcoholic fatty liver disease (called "fatty liver" for short) in subjects with normal fasting plasm a glucose (FPG). Methods 2003-11-01-30 the 158 patients with f atty liver and 316 control subjects (FPG<5.6mmol/L for all) were enrolled in this study. McAuley index, homeostasi s model assessment insulin resistance index (HOMA-IR) and fasting insulin (FINS) were applied to assess the status of insulin resistance. Result s Adjust ed with age and sex, body mass index (BMI), waist circumference(WC), waist-to h ip ratio, body fat percentage, systolic blood pressure, diastolic blood pressure , total cholesterol, low-dense lipoprotein cholesterol, triglyceride, HOMA-IR, a nd FINS were significantly higher in fatty liver patients than those in controls (P<0.001 for all). High-dense lipoprotein cholesterol and McAuley index were si gnificantly lower in fatty liver patients than those in controls (P< 0.001 for al l). Logistic regression analysis showed that BMI, WC, and McAuley index were the main risk factors for forming fatty liver. Conclusion The in dependent risk fa ctors for forming fatty liver are obesity and insulin resistance in subjects wi th normal FPG.