非酒精性脂肪与胰岛素抵抗及糖代谢异常的关系

目的 探讨非酒精性脂肪肝（脂肪肝）与胰素抵抗及糖代谢异常之间的关系。方法 对４８例脂肪肝患者做胰岛素释放试验和葡萄糖耐量试验,计算胰岛素曲线下面积,血糖曲线下面积和胰岛素敏感性指标（血糖曲线下面积／胰岛素曲线下面积）,并以不嗜酒的正常人作为对照组。结果 脂肪肝组口服葡萄糖６０ｍｉｎ,１２０ｍｉｎ,１８０ｍｉｎ后胰岛素水平高于对照组且高峰后移;除１８０ｍｉｎ外脂肪肝组的各时点的血糖水平显著高于对照级

Therelationship between nonalcoholic fatty liver and insulin resistance with abnormal glucosemetabolism

Objective To explore the correlation of nonalcoholic fatty liver(called "fatty liver" for short ) and insulin resistance with abnormal glucose metabolism. Methods The subjects were 48 patients with fatty liver, while the controls were 15 normal persons. Oral glucose tolerance test(OGTT) and insulin release test were performed; and the area under curve of serum glucose (AUCSG), area under curve of insulin(AUCIns) and insulin sensitivity index(AUCSG/ AUCIns) were calculated. Results The insulin level in fatty liver group was significantly higher than that in normal control group at 60 min, 120 min and 180 min after glucose intake(p < 0.01) with the postpond peak. The blood glucose level in the fatty liver group was significantly higher than that in normal cintrol group at all time intervals except at 180 min after glucose intake(p < 0.05). The AUCIns and AUCSG in the patient group were significantly higher than in the control group 209.56 vs 124.22, 24.72 vs 19.96, respectively(p < 0.01). The insulin sensitivity index in the patient group was signifi- cantly lower than that in the control group (P < 0.05). There is no significant difference in the insulin sensitivity index be- tween different degree of fatty liver (P > 0.05). Conclusion it is evident that patients with fatty liver have insulin resistance with abnormal glucose metabolism, which is not related with the extent of fat infiltration in the liver, suggesting that insulin resistance with abnormal glucose metbolism is a very important contributor to the pathogenesis of fatty liver.