非酒精性脂肪肝患者血清RBP4水平与胰岛素抵抗等相关性研究

目的探讨非酒精性脂肪肝患者血清视黄醇结合蛋白4（RBP4）及其与肥胖、胰岛素抵抗、血糖、血脂的关系：，方法选择非酒精性脂肪肝患者64例，正常对照35例，采用ELISA方法测定空腹血清RBP4，同时检测其身高、体重、腰围、臀围、血糖、血脂、肝功能及胰岛素水平，并计算体重指数（BMI）、腰臀比（WHR）和胰岛素抵抗指数（HOMA—IR）．结果与正常对照组比较，轻、中度非酒精性脂肪肝患者的BMI、wHR、FBG、TC、TG、LDL—C、FINS、HOMA—IR和RBP4显著增高（P〈0．01），相关分析显示，血清RBP4与BMI、WHR、FBG、TC、TG、LDL—C、FINS、HOMA—IR呈正相关。结论在非酒精性脂肪肝的发病过程中，RBP4可能参与了胰岛素抵抗。

Relationship between the Serum Retinol Binding Protein 4 and Insulin Resistance in Nonalcoholic Fatty Liver Disease

Objective To investigate the level of serum retinol binding protein 4 （RBP4） in patients with nonalcoholic fatty liver disease（NAFLD） and its relationship with obesity, insulin sensitivity, blood glucose, and blood lipid. Methods 64 patients with nonalcoholic fatty liver disease（NAFLD group） and 35 normal subjects（ normal control group） were selected. The level of serum RBP4 was measured by ELISA. Height, weight, waist circumstance, hip girth, fasting blood glucose（ FBG）, blood lipid （TC, TG, HDL-C, LDL-C） ,liver function（ AST, ALT） , and fasting insulin（ FINS ） were measured. Body mass index（ BMI ） , waist to hip ratio（WHR） ,homeostasis model assessment of insulin resistance（HOMA-IR） were calculated as well. Results Serum levels of FBG,TC,TG, LDL-C, FINS, RBP4 and HOMA-IR, BMI, WHR were higher in NAFLD patients as compared to normal controls （P 〈 0. 01 ）. And the moderate NAFLD group had higher FBG ,TC ,TG, LDL-C ,FINS, RBP4 and HOMA-IR, BMI, WHR as com- pared with the mild NAFLD group （ P 〈 0.01 ）. Serum RBP4 were positively correlated with BMI, WHR, FBG, TC, TG, LDL-C, FINS and HOMA-IR（ r = 0. 379,0.341,0.367,0. 359,0. 366,0. 342,0. 338,0.447 ,P 〈 0.01 ）. Conclusion Serum RBP4 was involved in the insulin resistance during the development of nonalcoholic fatty liver disease.