青年男性肝酶增高非酒精性脂肪肝患者糖耐量异常的研究  

Abnormal Glucose Tolerance Research in Young Male Nonalcoholic Fatty Liver Patients with Elevated Peptase

作　　者：刘哲慧[1,2] 李冠增[3] 田字彬[1] 

机构地区：[1]青岛大学医学院附属医院消化科,山东省青岛市266003 [2]聊城市人民医院保健科 [3]聊城市人民医院神经内科

出　　处：《中国全科医学》2011年第6期607-610,共4页Chinese General Practice

摘　　要：目的探讨口服葡萄糖耐量试验（OGTT）在非糖尿病非酒精性脂肪肝（NAFLD）患者中出现糖尿病症状前诊断糖尿病的价值。方法 175例18~35岁非糖尿病非酒精性脂肪肝青年男性患者禁食8h后进行OGTT,并检测丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素、γ-谷氨酰转肽酶、碱性磷酸酶、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、三酰甘油（TG）、空腹血糖（FBG）、空腹胰岛素（FINS）。在FBG和FINS基础上计算胰岛素抵抗指数（HOMA-IR）。结果 56例（32%）为正常血糖者。42例（24%）患者诊断为空腹血糖调节受损（IFG）,50例（28.6%）诊断为糖耐量降低（IGT）,27例（15.4%）患者诊断为糖尿病。体质量、BM I、腰臀比、AST、ALT、总胆红素、总胆固醇、LDL-C、TG、FBG、FINS、HOMA-IR在异常糖耐量NAFLD患者中明显增高,差异均有统计学意义（P〈0.01）。多元回归分析表明：年龄、FBG、HOMA-IR对糖耐量异常有独立影响作用（P〈0.05）。结论建议将OGTT作为肝酶升高NAFLD患者常规筛查糖尿病的一种手段。Objective To determine the relationship between nonalcoholic fatty liver disease（NAFLD） and the oral glucose tolerance test（OGTT） to predict preclinical diabetes in nondiabetic young male patients.Methods 175 male patients aged from 18 to 35 were enrolled in this study.A standard OGTT was carried out on all patients who had fasted for 8 hours.And ALT,AST,total bilirubin,γ-GT,ALP,total cholesterol,low density lipoprotein（LDL-C）,high density lipoprotein（HDL-C）,triglyceride（TG）,fasting blood glucose（FBG）,fasting insulin（FINS） were checked out.On the base of fasting blood glucose and fasting insulin,the homeostasis model for insulin resistance（HOMA-IR） was calculated.Results According to the OGTT results,56（32%） patients were diagnosed as normal glucose,42（24%） patients were diagnosed as having IFG,50（28.6%） patients were diagnosed as having IGT and.27（15.4%） patients were diagnosed as having diabetes.The NAFLD patients with abnormal glucose tolerance showed significant differences in age,weight,body mass index,waist-hip ratio,AST,ALT,total bilirubin,total cholesterol,low-density lipoprotein cholesterol,triglyceride,insulin,FPG and homeostasis model for insulin resistance（HOMA-IR）（P0.01）.Multiple regression analysis showed that age,FPG and HOMA-IR were independent predictors for abnormal glucose tolerance（P0.05）.Conclusion We recommend OGTT for NAFLD young male patients with elevated liver enzymes.It will be favourable to predict the type 2 diabetes.

关 键 词：青年男性 非酒精性脂肪肝 葡萄糖耐量试验 糖尿病 

分 类 号：R574.621[医药卫生—消化系统]