肥胖对非酒精性脂肪肝患者糖脂代谢的影响

目的探讨不同肥胖类型对非酒精性脂肪肝(NAFLD)患者代谢指标的影响。方法将351例NAFLD患者分为糖尿病组和非糖尿病组,再根据腰围、体质量指数分别分为腹型肥胖、非腹型肥胖亚组、体质量正常、超体质量、肥胖亚组,比较不同亚组间血糖、血脂谱、胰岛素抵抗指数和肝酶谱的差别。结果在非糖尿病组,腹型肥胖者2 h血糖、丙氨酸氨基转移酶(ALT)显著高于非腹型肥胖者(P<0.05);肥胖和超体质量者2 h血糖、空腹胰岛素、三酰甘油、ALT显著高于体质量正常者(P<0.05)。在糖尿病组,腹型肥胖者糖化血红蛋白显著高于非腹型肥胖者(P<0.05),肥胖者空腹血糖2、h血糖、糖化血红蛋白、胰岛素抵抗指数显著高于超体质量者和体质量正常者(P<0.05)。结论不同肥胖类型对NAFLD患者糖脂代谢、胰岛素抵抗有显著影响。

Impacts of obesity on metabolic profiles in patients with non-alcoholic fatty liver disease

Objective To explore impacts of different types of obesity on metabolic profiles in patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 351 cases of NAFLD patients were enrolled and divided into two groups(diabetic vs non-diabetic)and two or three sub-groups then according to their waist circumference and body mass index(abdominal obesity vs non-abdominal obesity and obese,overweight and normal weight).Blood glucose,lipid profiles,insulin resistance index and the liver enzymes were assessed and compared among different subgroups.Results In non-diabetic group,the patients with abdominal obesity assessed by waist circumference were observed with significantly higher 2 hour glucose level and alanine aminotransferase than that in patients without abdominal obesity(P<0.05).Those patients with obesity and overweight assessed by body mass index also showed significantly higher 2 hours glucose level,fasting insulin,triglyceride,alanine aminotransferase than that in the normal weight sub-group(P<0.05).In diabetes mellitus group,there were significantly higher plasma glycosylated hemoglobin in patients with abdominal obesity(P<0.05)and increased fasting glucose,2 hours glucose,glycated hemoglobin,insulin resistance index in patients with obesity than that in overweight and normal weight sub-group(P<0.05).Conclusion There are significant different effects of different types of obesity on glucose and lipid metabolism and insulin resistance in patients with NAFLD.