脂联素与非酒精性脂肪肝肝纤维化及胰岛素抵抗的关系

目的：研究脂联素水平与非酒精性脂肪肝（NAFLD）患者肝纤维化指标及胰岛素抵抗指数（IRI）的关系。方法：采用ELISA法检测NAFLD患者和正常对照组的脂联素水平及Ⅲ型前胶原（PCⅢ）、透明质酸（HA）、Ⅳ型胶原（CⅣ）、层黏蛋白（LN）水平，采用稳态模式胰岛素抵抗指数（HOMA IRI）评估胰岛素抵抗。结果：NAFLD组脂联素水平显著低于对照组，胰岛素抵抗指数与肝纤维化指标显著高于对照组（P〈0.05），IRI与PCⅢ、PCⅣ、HA和LN呈显著正相关（P〈0.05），脂联素水平与WHR、BMI、FBG、Tg、FINS、HOMA-IRI、PCⅢ、PCⅣ、HA和LN呈显著负相关（P〈0.01或〈0.05）。结论：NAFLD患者血清脂联素水平降低，脂联素的表达在NAFLD患者肝纤维化与胰岛素抵抗进程中可能起重要作用。

Relationship Between Adiponectin and Hepatic Fibrosis Markers Expressions as well as Insulin Resistance Index in patients with Non-alcoholic Fatty Liver Disease

Objective To investigate the retationship between expressions of adiponectin and hepatic fibrosis markers as well as insulin resistance index in patients with non - alcoholic fatty liver disease. Methods Serum adiponeetin, type Ⅲ pro -collagen （PCⅢ）, hyaluronic acid （HA）, type Ⅳ collagen （CⅣ）, laminin levels （with ELISA） and insulin resistance index （IRI） （calculated from homeostasis model assessment） were determined in 46 patients with non - alcoholic fatty liver disease （NAFLD） and 46 controls. ReSultS The serum adiponectin levels in patients with NAFLD were significantly lower than those in controls while the serum hepatic fibrosis markers （PCⅢ, HA, CⅣ, LN） levels and IRI were significantly higher than these in controls （P〈0.05）. IRI was significantly positively correlated with the hepatic fibrosis markers levels （ P 〈 0. 05 ）. Serum adiponectin levels were significantly negatively correlated with WHR, BMI, HOMA - IRI and levels of FRG, TG, FINS hepatic fibrosis markers （P 〈 0.05 or P 〈 0.01 ）. Conclusion Serum adiponectin levels were greatly reduced in patients with NAFLD, which might play important role in the increase of insulin resistance and development of hepatic fibrosis.