非肥胖的糖耐量受损者的非酒精性脂肪性肝病与代谢综合征的关系

目的探讨非肥胖的糖耐量受损(IGT)者的非酒精性脂肪性肝病(NAFLD)与代谢综合征(MS)的关系。方法126例非肥胖的IGT者,根据B超诊断有无NAFLD分为IGT伴NAFLD组64例,IGT不伴NAFLD组62例。对两组患者的体重指数(BMI)、血压、血糖、血脂、血胰岛素、稳态模型评估法胰岛素抵抗指数(HOMA-IRI)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及MS患病率等指标进行比较分析,并对NAFLD与上述指标的关系进行多因素的Logistic回归分析。结果IGT伴NAFLD组的BMI、空腹血糖、甘油三酯、胰岛素、HOMA-IR、ALT、AST及MS患病率较IGT不伴NAFLD组显著增高,而且NAFLD与MS及HOMA-IR呈独立相关。结论在非肥胖的IGT者中NAFLD与MS独立相关。MS不但明显增加NAFLD的发生率,而且还加重肝脏损害。     

2型糖尿病合并非酒精性脂肪肝的临床相关因素分析

目的：研究2型糖尿病合并非酒精性脂肪肝（NAFLD）患者的代谢特征,探讨其相关危险因素。方法：根据肝脏B超结果,将120例2型糖尿病患者分为NAFLD组和非NAFLD组,比较两组间的腰围、血脂、血糖、糖化血红蛋白（HbA1C）、C肽,计算并比较两组间的体重指数（BMI）、改良的胰岛素C肽指数（HOMA—C肤）。[结果]NAFLD组腰围、BMI、TG、LDL-C、HOMA-C肽均明显增高（P〈0．05）。结论：胰岛素抵抗、肥胖、高TG血症增加了2型糖尿病合并NAFLD的患病风险。     

2型糖尿病患者非酒精性脂肪肝的临床及代谢特点分析

目的探讨2型糖尿病（T2DM）患者非酒精性脂肪肝（NAFL）的临床及代谢特点。方法110例T2DM患者分为2组,T2DM合并NAFL为T2DMN组,60例;T2DM不伴NAFL为T2DM组,50例。通过分析2组之间病程、体重指数（BMI）、血压、空腹血糖（FBS）、尿酸（UA）、空腹胰岛素（FINS）、糖化血红蛋白（HbAlc）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、高密度脂蛋白（HDL-C）、甘油三酯（TG）、胰岛素抵抗指数（HOMA-IR）、胰岛素敏感指数（HOMA．ISI）等指标,了解T2DM合并NAFL的临床及代谢特点。结果T2DMN组的ALT、TG、HOMA．IR、UA均显著高于对照组,而HOMA．ISI、HDL-C则低于对照组,差异有统计学意义（P〈0．05）。BMI、UA、TG与糖尿病脂肪肝呈正相关（r=0．274、0．260、0．344,P〈0．05）;HOMA-ISI、HDL-C与糖尿病脂肪肝呈负相关（r=-0．154、-0．156,P〈0．05）。结论T2DM患者合并NAFL与血脂代谢紊乱、胰岛素抵抗（IR）及肥胖等有关,IR可能是NAFL发生发展的基础。     

2型糖尿病患者脂肪肝的回顾性调查及危险因素分析

目的 探讨2型糖尿病（T2DM）患者发生脂肪肝的患病率及危险因素.方法 对中山小榄人民医院336例诊断T2DM的住院患者进行回顾性分析,其中合并脂肪肝组178例,不合并脂肪肝组158例.结果 脂肪肝组与对照组比较,脂肪肝组体重指数（BMI）、腰臀比（WHR）、收缩压（DBP）、舒张压（SBP）、血清丙氨酸转氨酶（ALT）、糖化血红蛋白（HbA1c）、甘油三酯（TC）、胆固醇（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和空腹C肽（FCP）和空腹血糖（FBG）均显著升高（P＜0.05）;两组谷草转氨酶（AST）差异无统计学意义;脂肪肝组代谢综合征的发生率明显高于对照组.Logistic回归分析显示,FCP、BMI和WHR对脂肪肝的发生有显著影响（P＜0.05）.结论 2型糖尿病合并脂肪肝患者存在明显胰岛素抵抗;脂肪肝可能是代谢综合征的一个组成部分.FCP、体重指数、腰臀比为其重要危险因素.     

2型糖尿病合并非酒精性脂肪肝患者临床特征及相关因素分析

目的分析2型糖尿病合并非酒精性脂肪肝（NAFLD）患者的临床特点，探讨其相关因素。方法回顾性分析2008—2010年期间1007例2型糖尿病住院患者的临床资料，根据腹部B超结果分为无NAFLD组和NAFLD组。收集两组的年龄、病程等一般资料，身高、体重、体质指数（BMI）、糖化血红蛋白（HbA1c）、血脂、肝功能、肾功能、24h尿定量等检测指标的数据，进行Logistic回归分析。结果与无NAFLD组相比，NAFLD组年龄较小，糖尿病病程短，尿酸清除率降低，差异均有统计学意义（P〈0．01）；BMI、血尿酸（SUA）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转移酶（GGT）均升高，差异均有统计学意义（P〈0．01）。Logistic回归分析显示，NAFLD的发病随年龄、病程、BMI、肝酶（ALT、AST、GGT）水平、SUA水平增加而增加，差异有统计学意义（P〈O．01）。结论肥胖的2型糖尿病患者常伴有NAFLD。合并NAFLD的2型糖尿病患者易发生肝功能损害。升高的BMI、SUA可预示2型糖尿病患者NAFLD的发生。     

2型糖尿病合并非酒精性脂肪肝患者血清脂联素与胰岛素抵抗研究

目的分析2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）患者血清脂联素与胰岛素抵抗关系。方法测定2型糖尿病105例,其中合并NAFLD者73例,及正常对照组30例的脂联素、BMI、HOMA-IR等指标。结果T2DM合并重度NAFL组BMI、WHR、FINS、TG、VLDL、HOMA-IR均较T2DM无NAFL组显著增高（P〈0．0l或P〈0．05）;T2DM合并重度NAFL组BMI、WHR、FINS、HOMA．IR均较T2DM合并轻度NAFL组显著增高（P〈0．01或P〈0．05）。T2DM合并重度NAFL组血清脂联素水平显著低于他DM无NAFL组与T2DM合并轻度NAFL组（P〈0．01或P〈0．05）。Logistic逐步回归分析显示BMI、TG、脂联素、HO-MA-IR与T2DM合并NAFL密切相关（13=0．225,0．385,-0．548,0．421,P〈0．05）。结论2型糖尿病合并非酒精性脂肪肝以胰岛素抵抗为基础,脂联素与NAFL密切相关。     

老年非酒精性脂肪肝患者的临床分析

目的 研究老年非酒精性脂肪肝患者的临床代谢特点。方法分析老年非酒精性脂肪肝患者的临床特点和实验室资料。并采用病例对照研究，比较无糖尿病的非酒精性脂肪肝患者（NDF）和正常对照组（C）的体重指数、腹围、空腹血糖、血脂、胰岛素，采用稳态模式胰岛素抵抗指数（HOMA-IR）评价胰岛素抵抗。结果老年非酒精性脂肪肝患者中，肥胖者为60.85％，2型糖尿病患病率为39.53％，高血压痛惠病率为35.65％。72.12％的脂肪肝患者存在着高血压痛、冠心痛或脑卒中等心脑血管疾病。无糖尿病的非酒精性脂肪肝患者（NDF）与对照者（C）相比，体重指数（BMI）、腹围（WC）、空腹胰岛素（FINS）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-ch）和HOMA-IR均升高（P均〈0.05）。结论老年非酒精性脂肪肝患者中存在明显的胰岛素抵抗、血脂异常和肥胖现象；大多数非酒精性脂肪肝患者伴随着心脑血管疾病。     

瘦素受体基因多态性与2型糖尿病合并非酒精性脂肪肝的关系

目的探讨瘦素受体（LEPR）基因G3057A多态性与2型糖尿病合并非酒精性脂肪肝的关系。方法以216例新诊断的2型糖尿病患者（包括104例合并非酒精性脂肪肝）及108例正常糖耐量者作为受试对象，采用半巢式PCR-RFLP和PCR产物直接测序法检测各组的基因变异频率，ELISA法检测各组瘦素及胰岛素水平，常规检测血糖、血脂等代谢参数。结果2型糖尿病合并非酒精性脂肪肝组具有较高的谷丙转氨酶、甘油三酯、低密度脂蛋白胆固醇、瘦素水平和较低的胰岛素水平。其3057位核苷酸G—A变异频率为76．0％，也明显高于2型糖尿病不伴脂肪肝组及糖耐量正常组（分别为62．1．3％，53．2％），差异有统计学意义（X^2=14．63，P〈0．01）。结论LEPR第3057位核苷酸基因多态性可能通过调节机体脂质代谢、影响机体胰岛素敏感性等途径参与2型糖尿病合并非酒精性的发生。     

不同类型非酒精性脂肪肝与糖脂代谢的相关分析

目的评价不同程度肝脏脂质浸润对糖脂代谢的影响，并进行非酒精性脂肪肝（NAFLD）的相关因素分析。方法根据NAFLD患者是否伴有肝脏转氨酶升高及是否同时合并糖代谢异常，将受试对象253例分为单纯脂肪肝（FL）组、脂肪性肝炎（NASH）组、单纯脂肪肝合并糖调节受损（FLI）组、脂肪性肝炎合并糖调节受损（NSI）组和对照（NC）组，分析5组间糖脂代谢、舒张压（DBP）、收缩压（SBP）、体质指数（BMI）及腰围（WC）等方面的差异，并探讨各因素与NAFLD间的相关性。结果与NC组比较，其余4组WC、SBP、空腹血糖（FPG）、30min血糖（BG）、2hBG、空腹胰岛素（FINS）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、稳态模型胰岛素抵抗指数（HOMA-IR）明显升高，而高密度脂蛋白胆固醇（HDL-C）降低，差别有统计学意义（P〈0．05）。除对照组外，其余4组间比较，WC、LDL-C差别无统计学意义（P〉0．05）；NASH组与FL组、NSI组与FLI组比较，2hBG、TG、HDL-C差别无统计学意义（P〉0．05）；NSI组和FLI组比较，FINS无统计学意义（P〉0．05），其他各项指标均有统计学意义（P〈0．05）；FLI组与FL组、NSI组与NS组间比较，SBP、FBG、30minBG、2hBG、FINS、TG、HDL-C差别有统计学意义（P〈0．05）。进一步进行相关性分析发现，NAFLD与HOMA-IR间有独立的相关性归0．31，P〈0．05）。结论随着NAFLD并发NASH和（或）合并糖代谢异常可以进一步加重机体代谢紊乱，NAFLD患者尽管具有与NC组相似的BMI，WC和胰岛素抵抗指数（IR）仍明显增加，提示WC与NAFLD和IR间有明确的相关性，其作为中心性肥胖的指标优于BMI。     

超重肥胖儿童非酒精性脂肪肝病与代谢综合征相关性研究

【目的】了解超重肥胖儿童非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)中代谢综合征(metabolic syndrome,MS)的发病情况,探讨NAFLD与MS的相互关系。【方法】对212例超重肥胖儿童进行体格测量、血液生化检测和肝脏超声检查,分析NAFLD与MS的关系。【结果】共检出NAFLD患儿109例,MS 64例。腹型肥胖、高血糖、血脂紊乱、高血压、NAFLD和MS的检出率分别为85.8%、12.7%、57.1%、35.4%、51.4%和30.2%。与无NAFLD的103例相比,两组在体质指数、甘油三酯、稳态模型胰岛素抵抗指数(Homa-IR)和敏感指数(Homa-IAI)以及MS组分数等方面差异有高度统计学意义(P0.001)。腹型肥胖、高血糖、血脂紊乱、高血压发生NAFLD的比值比(OR)分别是非NAFLD组的2.168、2.348、2.145、2.418倍,而MS患者患NAFLD的风险最高(OR=3.109)。109例NAFLD患者中,108例存在1项或多项代谢紊乱,所有代谢紊乱都具有者15例(13.8%)。【结论】超重肥胖儿童NAFLD伴发MS较普遍,NAFLD与MS及其组分密切相关,是儿童MS在肝脏的表现。     

Predictors of non-alcoholic fatty liver in a group of non-obese and non-diabetic Iranian adults

Non-alcoholic fatty liver disease (NAFLD) is not uncommon in non-obese people. We examined the independent predictors of NAFLD in a group of non-obese and non-diabetic men and women in Rasht, Iran. Sixty-one adults aged 38.4 ± 8.4 years (32 men and 29 women) with body mass index (BMI) <30 kg/m² and non-diabetic with clinical features of NAFLD who visited our center between 2007 and 2009 were compared to 147 non-obese, non-diabetic and normal liver subjects (40 men and 107 women) aged 40.8 ± 9.1. Data on blood lipids, anthropometry, fasting blood glucose, exercise, and educational levels were gathered using a questionnaire. Logistic regression analysis revealed that weight gain during adulthood [OR = 1.90 (95% CI = 1.03–1.84), P < 0.04] and high serum triglyceride levels [OR = 1.19 (95% CI = 1.09–1.28), P < 0.0001] were independent predictors of NAFLD in this group of non-obese subjects. BMI, educational levels, gender, and habitual physical activity were not independently related to NAFLD in this study. These data suggest that weight gain after 20 years of age rather than BMI and high levels of triglyceride may serve as screening tool for NAFLD in clinical practice in this population. In nutritional management of these apparently normal weight subjects with NAFLD modest weight loss is necessary.     

非酒精性脂肪肝与代谢综合征的相关性研究

目的研究浙江省部分体检人群肥胖和代谢综合征（MS）的发病率,探讨非酒精性脂肪肝与代谢综合征及其组分的关系。方法选择在本院体检乙肝表面抗原阴性的3500例受检者,分别进行身高、体重、血压、丙氨酸氨基转移酶、血脂、血糖等生化指标检测及肝胆B超检查。结果非酒精性脂肪肝组的MS的患病率为25．49％,正常组MS的患病率为8．61％。两组比较差异有统计学意义（P〈0．05）。多因素回归分析非酒精性脂肪肝者患代谢综合征是对照组的3．927倍。非酒精性脂肪肝,体重指数和三酰甘油与代谢综合征显著相关。结论在浙江省部分人群中患非酒精性脂肪肝者,体重指数的增加和三酰甘油的升高是患代谢综合征的两个主要危险因素。     

Predictors of non-alcoholic fatty liver disease in obese children

OBJECTIVE: To evaluate predictors of non-alcoholic fatty liver disease (NAFLD) in obese children. DESIGN: Cross-sectional study. SUBJECTS: Two hundred and sixty-eight obese children not consuming alcohol and without hepatitis B or C were consecutively studied at an auxology clinic. MEASUREMENTS: Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl-transferase (GGT), cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, triglycerides, uric acid, glucose, glucose during oral glucose tolerance testing (OGTT), insulin, insulin during OGTT, insulin resistance as estimated by homeostasis model assessment (HOMA), C-reactive protein (CRP), and systolic and diastolic blood pressure were measured. Fatty liver was diagnosed by ultrasonography using standard criteria. Univariable and multivariable logistic regression was used to evaluate predictors of NAFLD. All predictors except gender and pubertal status were modeled as continuous variables. RESULTS: NAFLD was detected in 44% of obese children. At univariable analysis, male gender, Z-score of body mass index (BMI) (Z-BMI), ALT, AST, GGT, triglycerides, uric acid, glucose, glucose during OGTT, insulin, insulin during OGTT, HOMA, CRP and systolic blood pressure were predictors of NAFLD, whereas HDL-cholesterol and late-pubertal status were predictors of the normal liver. At multivariable analysis, however, only Z-BMI, ALT, uric acid, glucose during OGTT and insulin during OGTT were independent predictors of NAFLD. CONCLUSION: Z-BMI, ALT, uric acid, glucose during OGTT and insulin during OGTT are independent predictors of NAFLD in Italian obese children, with most of the prediction explained by ALT and Z-BMI.     

基于健康体检人群非酒精性脂肪肝简易筛查工具的研究

目的设计一个基于中国健康体检人群的非酒精性脂肪肝(NAFLD)的简易筛查工具。方法选取2017年1月至2017年12月在中国医科大学附属第一医院健康体检中心接受体检的人群作为研究对象,共纳入32578人。随机抽取80.00%的样本作为训练集构建筛查模型,计算筛检指数,剩余20.00%作为验证集对模型进行验证。结果逐步Logistic回归分析结果显示,体质指数(BMI)、空腹血糖(FPG)、血清甘油三酯(TG)、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶(AST/ALT)这四项指标纳入进了NAFLD的筛查模型,构建的NAFLD筛检指数=2×BMI+FPG+3×TG-7×(AST/ALT)。该指数在训练集中的受试者工作特征(ROC)曲线下的面积为0.883[95%CI:(0.879~0.887)],在验证集中的ROC曲线下面积为0.888[95%CI:(0.880~0.896)]。结论NAFLD筛检指数作为一个简单有效的筛查工具,可以用于大规模人群的普筛,具有一定的流行病学和卫生经济学意义。     

体质量与甘油三酯交互作用对老年非酒精性脂肪肝的关联分析

目的 探讨体质量（BMI）与甘油三酯（TG）之间交互作用对老年非酒精性脂肪肝（NAFLD）发病的影响。方法 2020年1—12月期间,采用便利抽样方法,以柳州市工人医院体检中心2 138名老年体检者为研究对象,进行横断面调查,内容涉及问卷调查,体格检查,生化指标检测及肝脏超声检查,并计算BMI。采用分类树模型CRT法对影响因素进行分析,非条件logistic回归模型分析影响因素间的交互作用。结果 （1）柳州市2 138例老年体检人群中,共检出NAFLD 872例,老年NAFLD患病率为40.8%（男性40.6%,女性41.1%）。老年NAFLD患者具有较高的BMI、收缩压（SBP）、舒张压（DBP）、TG、空腹血糖（FPG）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）及尿酸（UA）水平（P＜0.01）,而年龄和高密度脂蛋白胆固醇（HDL - C）水平均降低（P＜0.01）,总胆固醇（TC）和低密度脂蛋白胆固醇（LDL - C）水平无统计学意义（P＞0.05）。（2）建立分类树模型,包括5 层,27个结点,14个终末节点,结果显示与老年NAFLD关系最密切的2个变量为BMI和TG,该模型能够正确估计老年NAFLD患病比例的73.6 %。单因素和多因素logistic回归分析均显示高BMI与高TG对老年NAFLD具有显著的正交互作用,调整混杂因素后,高BMI与高TG间的相对超额危险度（RERI）、归因比（AP）、纯归因比（AP*）和交互作用指数（S）分别为7.54、49.56%、53.05%、2.13。结论 BMI与TG是老年NAFLD的重要危险因素之一,在老年NAFLD发病中存在协同交互作用,控制体质量及甘油三酯对降低老年人群NAFLD患病率起到重要作用。     

Independent Dose–Response Associations between Fetuin-A and Lean Nonalcoholic Fatty Liver Disease

Patients with lean NAFLD make up an increasing subset of liver disease patients. The association between lean NAFLD and feutin-A, which serves as a hepatokine and adipokine, has never been examined. Our study aimed to explore the association of serum fetuin-A among lean and non-lean patients. The study comprised 606 adults from the community, stratified into lean or non-lean (BMI </≥ 24 kg/m²) and NAFLD or non-NAFLD (scoring of ultrasonographic fatty liver indicator, US-FLI ≥ 2/< 2). Multivariate logistic regression analyses were performed to estimate the odds ratio of having NAFLD among the tertiles of fetuin-A after adjustment. The least square means were computed by general linear models to estimate marginal means of the serum fetuin-A concentrations in relation to the NAFLD groups. The odds ratio (OR) of having NAFLD for the highest versus the lowest tertile of fetuin-A was 2.62 (95% CI: 1.72–3.98; p for trend < 0.001). Stratifying by BMI, the OR of having lean NAFLD for the highest versus the lowest tertile of fetuin-A was 2.09 (95% CI: 1.09–3.98; p for trend 0.026), while non-lean NAFLD had no significant association with the fetuin-A gradient after adjustments. Fetuin-A was positively associated with lean NAFLD after adjusting for central obesity and insulin resistance.     

Nitrosative stress predicts the presence and severity of nonalcoholic fatty liver at different stages of the development of insulin resistance and metabolic syndrome: possible role of vitamin A intake

BACKGROUND: Although nonalcoholic fatty liver disease (NAFLD) is associated with the metabolic syndrome, the mechanisms responsible for the development of NAFLD at different stages of the development of insulin resistance are unknown. Diet, adipokines, and nitrosative stress have been linked to both NAFLD and insulin resistance. OBJECTIVE: We aimed to identify the factors that are specifically associated with NAFLD at different stages in the development of insulin resistance and the metabolic syndrome. DESIGN: Circulating concentrations of adipokines (ie, tumor necrosis factor-alpha, adiponectin, resistin, leptin, and interleukin-6), markers of nitrosative stress (nitrotyrosine), dietary habits, and MTP -493G/T polymorphism were cross-sectionally related to the presence and severity of insulin resistance (homeostasis model assessment index for insulin resistance: >or=2), the metabolic syndrome, and fatty liver in 64 nonobese nondiabetic patients with NAFLD (33 insulin-sensitive and 31 insulin-resistant subjects) and 74 control subjects without liver disease who were matched for sex, BMI, homeostasis model assessment index for insulin resistance status, and the various features of the metabolic syndrome. RESULTS: Persons with NAFLD had greater systemic nitrosative stress and a lower intake of vitamins A and E than did control subjects, but the 2 groups did not differ significantly in any other features. Nitrotyrosine and adiponectin concentrations and vitamin A intakes independently predicted alanine aminotransferase concentrations in NAFLD patients and liver histology in a subgroup of 29 subjects with biopsy-proven nonalcoholic steatohepatitis. CONCLUSIONS: Oxidative stress is operating in NAFLD and nonalcoholic steatohepatitis, even in the absence of insulin resistance, the metabolic syndrome, and hypoadiponectinemia, which aggravate liver histology at more severe stages of metabolic disease. The possible pathogenetic role of reduced vitamin A intake in NAFLD warrants further investigation.     

非酒精性脂肪肝患者血清抵抗素水平与胰岛素抵抗关系的研究

目的检测非酒精性脂肪肝（NAFLD）患者血清抵抗素水平,探讨抵抗素与胰岛素抵抗（IR）的关系,及其在NAFLD发生发展中的作用。方法选择NAFLD患者53例（男30例,女23例）,对照组28例（男16例,女12例）。以标准方法测量各研究对象身高、体重、腰围、臀围、血压。测定空腹血糖（FBG）、空腹胰岛素（FINS）、甘油三酯（TG）、总胆固醇（Tc）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、1-谷氨酰转移酶（GGT）,电化学发光免疫分析法（ECLIA）测定FINS,酶联免疫方法（ELISA）测定空腹血清抵抗素水平。通过公式计算体重指数（BMI）、腰臀比（WHR）、脂肪百分含量（BF％）,稳态模式评估法计算胰岛素抵抗指数（HOMA—IR）,对抵抗素与各指标之间的关系进行统计学分析。结果两组例数、年龄、性别及BF％比较差异均无统计学意义（P〉0．05）。NAFLD组收缩压（SBP）、舒张压（DBP）、WHR、腰围、臀围及BMI高于对照组（t=3．54,3．32,3．56,5．85,5．56,4．10,P=0．001）。两组TC、HDL-C及LDL-C水平比较差异均无统计学意义（P〉0．05）,而NAFLD组FBG、TG及AST高于对照组（P=0．001）。NAFLD组血清抵抗素水平、FINS、HOMA—IR、ALT、GGT均高于对照组（P=0．0005）。NAFLD组血清抵抗素与年龄、BMI、WHR、BF％、FBG、TG、TC、HDL-C、LDL-C、AST无关（P〉0．05）。血清抵抗素与GGT、ALT、FINS、HOMA-IR呈正相关（r=0．354,0．391,0．875,0．881,P〈0．05或P〈0．01）。多元逐步回归分析显示：HOMA-IR对血清抵抗素水平影响最显著。NAFLD组男性和女性患者血清抵抗素水平均高于对照组中的男性和女性受检者（P〈0．05）,两组中男女性之间比较差异无统计学意义（P〉0．05）。结论NAFLD患者血清抵抗素水平显著高于正常人,其血清抵抗素与IR密切相关,可能主要与肝源性IR有关,且参与NAFLD的发生。血清抵抗素可能作为促炎因子参与脂肪肝炎症的发生。