女性非酒精性脂肪性肝病脂联素水平与胰岛β细胞功能及胰岛素抵抗的相关性  

Relationship between adiponectin and β-cell function and insulin resistance in female patients with nonalcoholic fatty liver disease

作　　者：查英[1] 刘军[1] 盛励[1] 陈灶萍[1] 杨玲娣[1] 陈钦达[2] 廖晓寰[3] 孟令平[4] 

机构地区：[1]复旦大学附属上海市第五人民医院内分泌科,上海200240 [2]复旦大学附属上海市第五人民医院生化室,上海200240 [3]复旦大学附属上海市第五人民医院免疫室,上海200240 [4]复旦大学附属上海市第五人民医院核磁共振室,上海200240

出　　处：《临床肝胆病杂志》2011年第4期420-423,共4页Journal of Clinical Hepatology

基　　金：上海市卫生局青年科研基金资助项目(054Y44)

摘　　要：目的探讨女性非酒精性脂肪性肝病(NAFLD)脂联素水平与胰岛β细胞功能、胰岛素抵抗之间的关系。方法应用高葡萄糖钳夹技术检测了9例NAFLD组和7例正常对照组(C)胰岛β细胞功能和胰岛素敏感性,采用梯度回波化学位移MRI评估了肝脏inphase(IP)值和outphase(OP)值,并测定了皮下脂肪面积(SA)、内脏脂肪面积(VA)。用酶联免疫法测定脂联素(adiponectin)水平。结果 NAFLD组空腹胰岛素(FINS)、胰岛素分泌第一时相(1Ph)、葡萄糖代谢清除率(M)、胰岛素敏感指数(ISI)和脂联素水平低于C组(P<0.05)。Spearman相关分析显示,脂联素与M(r=0.526,P=0.036)、ISI(r=0.682,P=0.005)、1Ph(r=0.676,P=0.003)、肝脏OP值(r=0.682,P=0.004)和肝脏OP/IP(r=0.594,P=0.015)呈正相关。结论女性NAFLD患者脂联素水平降低,低脂联素血症可能与胰岛素抵抗、胰岛功能早期损害密切相关。Objective To investigate adiponectin level in female patients with nonalcoholic fatty liver disease（NAFLD）,and to explore the relationship between adiponectin and ？-cell function and insulin resistance.Methods The investigation used case control study.Nine patients with nonalcoholic fatty liver disease（NAFLD） and seven control subjects（C） were analyzed for ？-cell function and insulin resistance by hyperglycemic clamp.Serum adiponectin was assayed by ELISA.Subcutaneous adipose areas（SA）,visceral adipose areas（VA）,liver inphase（IP） and outphase（OP）were measured by MRI.Results The result showed the levels of fasting insulin（FINS）,first phase insulin release（1Ph）,glucose disposal rates（M）,insulin sensitivity index（ISI）,and adiponectin were significantly lower in NAFLD than those in C group（P〈0.05）.Spearman correlation analysis showed adiponectin was positively associated with M（r=0.526,P=0.036）,ISI（r=0.682,P=0.005）,1Ph（r=0.676,P=0.003）,liver OP（r=0.682,P=0.004） and OP/IP（r=0.594,P=0.015）.Conclusion The result suggested that adiponectin level was decreased in female patients with NAFLD.Hypoadiponectinemia may be associated with insulin resistance and early beta-cell dysfunction in NAFLD.

关 键 词：脂肪肝 脂联素 胰岛 胰岛素抗药性 

分 类 号：R575.5[医药卫生—消化系统]