高血压合并脂肪肝与胰岛素抵抗的相关分析

目的：探讨高血压合并脂肪肝与胰岛素抵抗（IR）的相关性。方法：根据超声影像学的诊断结果将住院治疗的高血压患者分为高血压合并脂肪肝组（98例）和高血压未合并脂肪肝组（104例），研究两组的体重指数（BMD、血压（BP）、血糖、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、肝酶和血浆胰岛索，胰岛素抵抗指数（IRI）水平。结果：高血压合并脂肪肝组较高血压未合并脂肪肝组的血糖、胰岛素水平、甘油三酯和胰岛素抵抗指数均明显增高（P〈0．05）。Logistic回归结果表明空腹血糖（FBG）、肥胖、丙氨酸氨基转氨酶（ALT）、葡萄糖负荷试验后3h胰岛素水平、甘油三醋（TG）是脂肪肝形成的独立危险因素（OR=1．980～3．245，P〈0．05）。结论：高血压和脂肪肝均是胰岛素抵抗的重要表现，高血压合并的脂肪肝其发病机制与胰岛素抵抗有关。

Correlation between hypertension with fatty liver and insulin resistance

Objective:To explore the correlation between hypertension with fatty liver and insulin resistance.Methods:Body mass index(BMI),blood pressure(BP),plasma glucose,triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL),liver function,serum insulin and HOMA-IR were investigated in 98 patients with hypertension and fatty liver and 104 hypertension patients without fatty liver diagnosed by B ultrasonic echography.Results:The plasma glucose,serum insulin,TG,HOMA-IR in patients with hypertension and fatty liver were higher than those of the simple hypertensive controls (P<0.05).The result of logistic regression equation suggested that the fasting blood glucose,obesity,ALT,TG and serum insulin (3 h after oral glucose tolerance test) were independent risk factors of fatty liver(OR=1.980~3.245,P<0.05 all).Conclusion:Insulin resistance plays an important role in both hypertension and fatty liver and correlates with pathogeny mechanism of hypertension with fatty liver.