非酒精性脂肪肝患者胰岛β细胞功能的表达  

The expression of Beta cell Function in nonalcoholic fatty liver patients

作　　者：王萍萍[1,2] 柳光栋[2] 王林[2] 韩先起[2] 王洪安[2] 王颜刚[3] 

机构地区：[1]青岛大学医学院研究生部,山东青岛266003 [2]即墨市人民医院特需内科,山东即墨266200 [3]青岛大学医学院第一附属医院内分泌科,山东青岛266003

出　　处：《中国医药导报》2011年第20期43-45,共3页China Medical Herald

摘　　要：目的:探讨非酒精性脂肪肝患者胰岛β细胞的功能和胰岛素抵抗的特征。方法:研究对象收集于青岛大学医学院附属医院和即墨市人民医院,共60例,分为非酒精性脂肪肝组30例,正常对照组30例,对两组体重指数、糖化血红蛋白、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血糖、胰岛素水平进行比较,同时采用胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗性,胰岛素曲线下面积反映胰岛β细胞在葡萄糖刺激下总体分泌胰岛素情况,早相胰岛素分泌指数(△I30/△G30)、胰岛β细胞功能(HOMA-β)评估早时相和晚时相胰岛素分泌功能,并对各指标和影响因素之间进行相关性分析。结果:非酒精性脂肪肝病(NAFLD)组的BMI、TC、TG、HDL-c、LDL-c、HbA1c、0 min、30 min、120 min血糖均高于对照组(t=4.877,3.677,2.388,3.589,2.616,2.21,3.850,2.254,3.913,P=0.001,0.001,0.020,0.002,0.031,0.001,0.014,0.001,0.02),NAFLD组HOMA-IR高于对照组(t=4.482,P=0.001),两组间的早相分泌和晚相分泌、曲线下面积无差异(P>0.05)。HbA1c、TC、0 min、60 min、120 min血糖与胰岛素抵抗相关(R=0.542、R=0.675、R=0.832、R=0.499、R=0.974,P<0.05);HDL-c、0 min血糖、0 min胰岛素与早时相分泌相关(R=-0.556、R=0.519、R=0.529,P<0.05);0 min血糖、0 min胰岛素与晚时相相关(R=-0.771、R=0.767,P<0.05)。结论:非酒精性脂肪肝组存在胰岛素抵抗,胰岛β细胞功能在早期尚未受损。Objective：research the functionality of insulin β cell and the characteristics of insulin resistance of the patients with non alcoholic fatty liver disease（NAFLD）.Methods：Research subjects were collected from the teaching hospital of Qingdao University and the People＇s Hospital of Jimo City.The total number was 60 with NAFLD（experiment group） 30 and non-NAFLD（control group） 30.Compare the glycosylated hemoglobin,BMI,blood-fat,blood sugar and insulin level of the two groups.In addition,evaluate the insulin resistance with HOMA-IR method,the bottom area of the insulin curve reflects the overall states of how insulin βcell secretes insulin.△I30/△G30,HOMA-βevaluate the secreting functionality of the early phase insulin and late phase insulin,the parameters and their affecting factors are analyzed with correlation.Results：The weight,BMI,TC,TG,HDL-C,LDL-C,HbA1c,0 min,30 min,120 min blood sugar are all higher than those of the control group（t=4.877,3.677,2.388,3.589,2.616,2.21,3.850,2.254,3.913,P=0.001,0.001,0.020,0.002,0.031,0.001,0.014,0.001,0.02）.The HOMA-IR of NAFLD was also greater（t=4.482,P=0.001）,there are little difference between the curve bottom area of early phase secreting and late phase secreting（P0.05）.HbA1c,TC,0 min,60 min,120 min blood sugar is correlated with IR（R=0.542,R=0.675,R=0.832,R=0.499,R=0.974,P0.05）;HLD-c,0 min blood sugar,0min insulin is correlated with early phase secreting（R=-0.556,R=0.519,R=0.529,P0.05）;0 min blood sugar,0 min insulin was correlated with late phase secreting（R=-0.771,R=0.767,P0.05）.Conclusion：Patients with non alcoholic fatty liver disease have insulin resistance and insulin β cell is not impaired in the early stage.

关 键 词：非酒精性脂肪肝 胰岛素抵抗 胰岛Β细胞功能 

分 类 号：R575.5[医药卫生—消化系统]