| 非酒精性脂肪性肝病进展性肝纤维化患者空腹血糖受损和胰岛素抵抗调查 |
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| 引用本文： | 王晓华,曾雅琳,郭萃蓉. 非酒精性脂肪性肝病进展性肝纤维化患者空腹血糖受损和胰岛素抵抗调查[J]. 实用肝脏病杂志, 2022, 25(6): 812-815. DOI: 10.3969/j.issn.1672-5069.2022.06.014 |
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| 作者姓名： | 王晓华 曾雅琳 郭萃蓉 |
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| 作者单位： | 410000 长沙市 南华大学附属长沙中心医院健康管理中心 |
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| 基金项目： | *长沙市卫生健康委员会科研资助项目[编号:长卫发(2018)69号] |
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| 摘 要： | 目的 调查非酒精性脂肪性肝病(NAFLD)患者空腹血糖受损(IFG)和胰岛素抵抗情况及其与肝纤维化的关系。方法 2020年5月～2021年5月我院健康管理门诊诊治的NAFLD患者110例，接受口服葡萄糖耐量试验(OGTT)试验。计算稳态模型胰岛素抵抗指数(HOMA-IR),采用放射免疫法测定血清Ⅳ型胶原、Ⅲ型前胶原(PCⅢ)、层黏连蛋白(LN)和透明质酸(HA)。计算NAFLD纤维化评分(NFS),以NFS﹥0.676被定义为存在进展性肝纤维化。应用Logistic回归模型分析影响NAFLD患者发生进展性肝纤维化的因素。结果 经OGTT试验，发现本组糖耐量正常(NGT)者43例，糖耐量异常(IGT)者35例和IFG者32例；IFG组空腹血糖(FPG)、胰岛素(FINS)和HOMA-IR指数分别为(6.6±0.3)mmol/L、(10.9±2.4)μU/mL和3.2±0.9,显著高于IGT组【分别为(5.6±0.7)mmol/L、(8.5±2.2)μU/mL和2.4±0.5,P<0.05】或NGT组【分别为(5.5±0.6)mmol/L、(7.4±1.9)μU/mL和1.8±0.4...
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| 关 键 词： | 非酒精性脂肪性肝病 空腹血糖受损 胰岛素抵抗 肝纤维化 |
| 收稿时间： | 2022-03-21 |
Impact of impaired fasting glucose and insulin resistance on liver fibrosis in patients with nonalcoholic fatty liver diseases |
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| Wang Xiaohua,Zeng Yalin,Guo Cuirong. Impact of impaired fasting glucose and insulin resistance on liver fibrosis in patients with nonalcoholic fatty liver diseases[J]. Journal of Clinical Hepatology, 2022, 25(6): 812-815. DOI: 10.3969/j.issn.1672-5069.2022.06.014 |
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| Authors: | Wang Xiaohua Zeng Yalin Guo Cuirong |
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| Affiliation: | Health Management Center, Central Hospital Affiliated to Nanhua University, Changsha 410000, Hunan Province, China |
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| Abstract: | Objective The aim of this study was to analyze the impact of impaired fasting glucose (IFG) and insulin resistance (IR) on liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 110 patients with NAFLD were encountered in the Health Management Clinic between May 2020 and May 2021. All individuals underwent oral glucose tolerance test (OGTT), and the homeostasis model insulin resistance index (HOMA-IR) was calculated. Serum type IV collagen, type III procollagen (PCIII), laminin (LN) and hyaluronic acid (HA) levels were detected by radioimmunoassay. The NAFLD fibrosis score (NFS) was calculated and the progressive liver fibrosis (PLF) was defined as the NFS﹥0.676. The multivariate Logistic regression analysis was applied to reveal the risk factors for PLF occurrence. Results Based on the OGTT results, the normal glucose tolerance (NGT) was found in 43 cases, the impaired glucose tolerance (IGT) in 35 cases and the IFG in 32 cases; the fasting plasma glucose, insulin and HOMA-IR in patients with IFG were (6.6±0.3) mmol/L, (10.9±2.4) μU/mL and 3.2±0.9, significantly higher than [(5.6±0.7) mmol/L, (8.5±2.2) μU/mL and 2.4±0.5, P<0.05] in patients with IGT or [(5.5±0.6) mmol/L, (7.4±1.9) μU/mL and 1.8±0.4, P<0.05] in patients with NGT; serum collagen IV, PCIII, LN and HA levels in patients with IFG were (75.7±9.6) ng/mL, (146.3±13.1) ng/mL, (132.7±15.2) ng/mL and (189.6±17.5) ng/mL, significantly higher than [(63.9 ± 8.4) ng/mL, (133.3 ± 10.7) ng/mL, (122.4 ± 13.4) ng/mL and (163.9 ± 18.6) ng/mL, P<0.05] in patients with IGT or [(59.4 ± 7.4) ng/mL, (128.6 ± 11.6) ng/mL, (109.4 ± 8.9) ng/mL and (150.2 ± 13.2) ng/mL, P<0.05] in patients with NGT; the PLF was found in 18 patients in our series, and the multivariate Logistic regression analysis showed that the IFG (OR=1.528) and IR (OR=1.714) were the independent risk factors for PLF in patients with NAFLD (P<0.05). Conclusion When the IFG occurs in patients with NAFLD hint the IR, which might promote liver fibrosis progression. |
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| Keywords: | Nonalcoholic fatty liver disease Impaired fasting glucose Insulin resistance Liver fibrosis |
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