高血压病患者非酒精性脂肪肝病与胰岛素抵抗关系探讨

探讨高血压病患者的非酒精性脂肪肝病（NAFLD）与胰岛素抵抗（IR）的关系。190例不伴有糖尿病的患者分为正常血压和高血压组;再根据B超诊断有无脂肪肝将高血压组分为伴NAFLD 48例（观察组）,高血压不伴NAFLD 50例（对照组）。对两组间及高血压组内的体重指数（BM I）、血压、血糖、血脂、血胰岛素、胰岛素抵抗指数（HOMA-IR）及转氨酶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logistic回归分析。经相关分析显示：HMOA-IR与血压升高呈显著负相关;高血压伴NAFLD组的BM I、甘油三酯、空腹胰岛素、口服75g葡萄糖后2h胰岛素、ALT,AST及HOMA-IR较不伴NAFLD组显著增高（P〈0.05-0.01）,而且NAFLD与HOMA-IR及ALT呈独立相关（P〈0.05,0.01）。高血压病伴NAFLD患者有更显著的IR,而且在非糖尿病患者中,IR是高血压和NAFLD的独立危险因素。

Relationship between nonalcoholic fatty liver disease and insulin resistance in hypertensive patients

To investigate the relationship between insulin resistance and nonalcoholic fatty liver disease(NAFLD) in hypertensive patients.109 non-diabetic hypertensive patients were grouped as normal controls(n=92) and hypertensive(n=98) that included hypertensive patients with NAFLD(n=48) and hypertensive patients without NAFLD(n=50) diagnosed with ultrasonography.BMI,blood pressure,fastinsulin and OGGT 2-hour glucose,TG and ALT were measured.Insulin resistance(IR) was estimated from fasting insulin and glucose as the homeostasis model assessment(HOMA) index.Multivariate logistic regression analysis was used to identify the variables associated with NAFLD.Multiplecorrelation analysis showed that HOMA-IR was negatively correlated with elevation of blood pressure.The group with NAFLD had significantly higher BMI(P<0.01),TG(P<0.01),fastinsulin, OGGT 2-hour glucose(P<0.01),ALT(P<0.01),AST(P<0.05) and HOMA-IR(P<0.05) compared with the group without HAFLD.Hypertensive patients with NAFLD had significantly higher insulin resistance compared with those without NAFLD.Insulin resistance might be an independent risk factor for non-diabetic hypertensive patients with NAFLD.