非酒精性脂肪肝合并高血压患者血清脂联素水平的研究

目的 研究非酒精性脂肪肝(NAFLD)合并高血压患者血清脂联素水平与胰岛素抵抗(HO-MA)程度的相关性.方法 性别匹配的NAFLD合并高血压患者65例,单纯NAFLD患者51例,健康体检者54例作为对照组.测定体质指数(BMI),检测空腹血糖(FBS)、丙氨酸氨基转移酶(ALT)、胆固醇、甘油三酯(TG)等生化指标并行肝脏B超检查.放射免疫法测定空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HO-MA-IR).同时酶联免疫法测定血清脂联素水平.并用相关及多元回归分析血清脂联素水平与各参数的相关性.结果 NAFLD患者BMI(27.12±2.63)kg/m2]、ALT(35.86±20.16)U/L]、TG(2.73±1.43)mmol/L]、FBS(5.71±0.65)mmol/L]、FINS(12.33±4.16)mIU/L]、HOMA-m(3.11±1.04)]水平较对照组高(23.14±2.86)kg/m2、(19.72±8.90)U/L、(1.35±0.59)mmol/L、(5.19±0.78)mmol/L、(2.31±1.61)mIU/L、0.53±0.39]P＜0.05),脂联素水平较对照组低((4.52±2.05)、(8.88±3.37)μg/ml]P＜0.05);NAFLD 合并高血压患者HOMA-IR较单纯NAFLD患者更高(4.47±2.87、3.11±1.04,P＜0.05),脂联素水平更低((3.19±1.52)、(4.52±2.05)μg/ml,P＜0.05).结论 NAFLD合并高血压患者HOMA-IR、FINS较NAFLD更为严重,脂联素水平更低.脂联素与BMI、ALT、FBS、FINS、TG、HOMA呈负相关,与性别相关,与年龄、胆固醇相关不明显.脂联素与TG以及HOMA相关.

Hypoadiponectinemia in non-alcoholic fatty liver disease with hypertension

Objective To explore the relationship of serum adiponectin concentration in patients of non-alcoholic fatty liver disease(NAFLD}with essential hypertension(EH)with insulin resistance.Methods 65 NAFLD patients with EH,51 patients with NAFLD,54 healthy controls were studied.Abdominal ultrasound was taken for fatty liver examination.Serum adiponectin and insulin levels were determined by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (PIA).Insulin resistance indexes were assessed.Other anthropometric and biochemical variables(including BMI,FBS,ALT,TC and TG)were measured by routine methods.Results The body mass index(BMI)-serum total triglycerin(TG),fasting blood Sugar(FBS),aspartate transaminase(ALT)level,fasting insulin(FINS)and HOMA were significanfly increased(P＜0.05),serum adiponectin was significantly decreasde in NAFLD compared with healthy controls(P＜0.05).Besides,compared with NAFLD,HOMA was significantly increased(P＜0.05)and serum adiponectin wag significantly decreased in NAFLD with EH(P＜0.05).Conclusion compared with NAFLD,NAFLD with EH has further extent of insulin resistance and lower hypoadiponectinemia.Adiponectin is negatively correlated with BMI,ALT,FBS,FINS,TG and HOMA,but not sisnificantly related to age and cholesterol.TG and HOMA are related to adiponectin.