脂联素/瘦素比值用于判断非酒精性脂肪肝严重程度的可行性研究  

A feasibility study of adiponectin to leptin ratio for severity of nonalcoholic fatty liver disease

作　　者：孔银[1] 赵睿[1] 王亮[1] 何晶晶[1] 李光明[1] 王娟霞[1] 丁洁[1] 李娟[1] 张岭漪[1] 

机构地区：[1]兰州大学第二医院肝病科,甘肃省消化肿瘤重点实验室,730030

出　　处：《国际消化病杂志》2013年第4期264-268,共5页International Journal of Digestive Diseases

基　　金：甘肃省科学事业费科技项目(QS012-C33-41)

摘　　要：目的研究非酒精性脂肪性肝病(NAFLD)患者血清脂联素/瘦素(A/L)与胰岛素抵抗(IR)的关系,探讨血清A/L在NAFLD严重程度分级中的意义。方法将78例确诊NAFLD患者,依据彩色超声诊断仪显像结果,分为轻度NAFLD组31例,平均年龄为(50±14)岁,男女比例为19∶12;中重度NAFLD组47例,平均年龄为(49±14)岁,男女比例为27∶20。同期观察体检健康志愿者30例作为对照组,平均年龄(48±10)岁,男女比例为18∶12。ELISA法测定血清瘦素(LP)、脂联素(APN)水平,并检测体质量指数(BMI)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、三酰甘油(TG)、总胆固醇(CHO)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、空腹血糖/胰岛素、稳态模型评估的胰岛素抵抗指数(HOMA-IR)。采用SPSS17.0软件包进行统计学分析,计量资料差异性比较用方差分析,多因素相关性用Pearson分析。结果血清LP与HOMA-IR、LDL和BMI均呈正相关(r=0.296,P=0.000;r=0.327,P=0.000;r=0.282,P=0.001),血清APN与HOMA-IR、LDL和BMI均呈负相关(r=-0.375,P=0.000;r=-0.368,P=0.000;r=-0.285,P=0.001)。A/L与HOMA-IR、LDL和BMI均呈显著负相关(r=-0.398,P=0.000;r=-0.374,P=0.000;r=-0.307,P=0.000),且NAFLD轻度组的相关系数(r=-0.311)大于中重度组(r=-0.486)。结论本研究对NAFLD患者检测发现,A/L与HOMA-IR呈显著负相关。初步提示血清A/L比值可作为一种非侵入性检测指标,有助于NAFLD严重程度的临床分级。Objective The aim of this study was to investigate the relationship between serum adiponectin to leptin （A/L） and insulin resistance （IR） in nonalcoholic fatty liver disease （NAFLD）, and to determine the significance of serum A/L levels in the prediction of the severity of NAFLD. Methods According to the type-B ultrasonic, seventy eight patients with NAFLD were divided into two groups, the mild group NAFLD （n = 31, mean age 50 ± 14, male ： female = 19 ： 12）, and the moderate and severe group NAFLD （n = 47, mean age 49±14, male ： female = 27 ： 20）. Meanwhile, healthy volunteers were treated as normal control group（n= 30, mean age 48 ± 10, male ： female = 18 ： 12）. The serum levels of leptin and adiponectin were measured by ELISA. The body mass index （BMI）, alumina aminotransferase （ALT）, aspartate aminotransferase （AST）, triglyceride （TG）, total cholesterol （CHO）, high-density lipoprotein cholesterol （HDL）, low-density lipoprotein cholesterol （LDL）, fasting blood glucose （FBG）, fasting insulin （FIN）, homeostasis model assessment insulin resistance （HOMA-IR） were detected and analyzed. Results Serum leptin were positively correlated with HOMA-IR （r = 0. 296, P = 0. 000）, LDL （r = 0. 327, P = 0. 000） and BMI （r = 0. 282, P = 0. 001）. Serum adiponectin levels were negatively correl.ated with HOMA-IR （r= -0.375, P= 0. 000）, LDL （r= - 0. 368, P= 0. 000） and BMI （r= - 0. 285, P = 0. 001）. A/L were negatively correlated with HOMA-IR （r= - 0. 398, P = 0. 000）, LDL （r= - 0. 374, P = 0. 000） and BMI （r= - 0. 307, P = 0. 000）. The coefficient correlation of A/L ratio were significant higher in the mild group NAFLD （r = -0. 311 ） compared with the moderate and severe group NAFLD （r = - 0. 486）. Conclusions The A/L ratio was inversely related to the HOMA-IR in NAFLD. The serum A/L level may be a useful noninvasive approach to appreciate the severity of NAFLD.

关 键 词：脂联素 瘦素 脂联素 瘦素比值 非酒精性脂肪性肝病 

分 类 号：R575.5[医药卫生—消化系统]