代谢正常肥胖合并非酒精性脂肪性肝病的临床特征及内皮功能研究  

Clinical features and endothelial function in metabolically healthy obese patients with nonalcoholic fatty liver disease

作　　者：贺肴 张弛[1] 刘瑛[1] 谢环[1] 张沥[1] 李华珠[1] 杨晓春[1] 周桂莲[1] 王敏[1] 

机构地区：[1]湖南师范大学第一附属医院,湖南省人民医院内分泌科,长沙410005

出　　处：《国际内分泌代谢杂志》2015年第3期163-165,169,共4页International Journal of Endocrinology and Metabolism

基　　金：湖南省科技计划基金资助项目（2011SK3160）;湖南省保健委重点基金项目（A2009-02）;湖南省卫生厅重点基金资助项目（A2007005）

摘　　要：目的 探讨代谢正常肥胖（MHO）合并非酒精性脂肪性肝病（NAFLD）患者的临床、生化特征及内皮功能.方法 收集湖南省人民医院体检中心2006年4月-2014年1月体检人群的资料,排除资料不完整者,共5 147名.选择诊断为MHO患者（共478例）纳入研究,其中234例合并NAFLD（MHO合并NAFLD组）,244例未合并NAFLD（MHO未合并NAFLD组）.共获得56例MHO（29例为MHO合并NAFLD,27例为MHO未合并NAFLD）患者的血标本,检测C反应蛋白（CRP）、血清空腹胰岛素（FINS）、脂联素、内皮素-1,计算稳态模型评估-胰岛素抵抗指数（HOMA-IR）,记录受检者身高、体重、收缩压、舒张压、甘油三酯、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）、空腹血糖、谷丙转氨酶（ALT）、尿酸、外周血白细胞计数（WBCC）及腹部B超结果.比较MHO合并NAFLD组与MHO未合并NAFLD组临床、生化特征、炎性因子及内皮素-1水平的差异.结果 MHO合并NFALD组与MHO未合并NAFLD组相比,年龄（t=-4.164）、体重指数（t=-4.519）、收缩压（t =-3.892）、空腹血糖水平（t=-2.549）、ALT（t =-2.019）、HOMA-IR（u=-2.091）、内皮素-1水平（u=-3.632）升高,脂联素水平（u=-2.206）降低（P均＜0.05）.而性别、舒张压、甘油三酯、总胆固醇、LDL-C、HDL-C、尿酸、WBCC、FINS、CRP在两组间差别无统计学意义.结论 MHO合并NAFLD患者者代谢异常加重,内皮功能紊乱.Objective To investigate the clinical parameters,biochemical parameters and endothelial function in metabolically healthy obese（MHO） patients with nonalcoholic fatty liver disease （NAFLD）.Methods Data from 5 147 subjects undergone physical examination from April 2006 to January 2014 were collected in People＆#39;s Hospital of Hunan Province.Among which 478 were diagnosed with MHO,and were included in this study.They were divided into two groups according to NAFLD status：MHO with NAFLD group （n =234）,MHO without NAFLD group（n =244）.In addition,blood samples from 56 subjects （29 MHO with NAFLD,27 MHO without NAFLD） were preserved to detect C-reactive protein（CRP）,fasting insulin（FINS）,adiponectin and endothelin-1 level.Homeostasis model assessment-insulin resistance index （HOMA-IR） was calculated.Body height,body weight,systolic blood pressure,diastolic blood pressure,triglyceride,total cholesterol,low density lipoprotein cholesterol （LDL-C）,high density lipopro-tein cholesterol （HDL-C）,fast blood glucose,alanine aminotransferase （ALT）,uric acid,peripheral white blood cell count（WBCC） and abdominal B ultrasound were recorded.Clinical parameters,metabolic parameters,the level of inflammatory cytokines and endothelin-1 were compared between MHO with NAFLD group and MHO without NAFLD group.Results Compared with MHO without NAFLD group,age（t =-4.164）,body mass index（t=-4.519）,systolic blood pressure （t =-3.892）,fast blood glucose （t =-2.549）,ALT （t =-2.019）,HOMA-IR （u=-2.091）,endothelin-1 （u=-3.632） were higher than those in MHO with NAFLD group,and adiponectin was lower than that in MHO with NAFLD group （u=-2.206,all P 〈0.05）.There was no difference in sex,diastolic blood pressure,triglyceride,total cholesterol,LDL-C,H DL-C,uric acid,peripheral WBCC,FINS,CRP between the two groups.Conclusions Patients with MHO and NAFLD have aggravated metabolic abnormalities and endothelial dysfunction.

关 键 词：肥胖 代谢正常肥胖 非酒精性脂肪性肝病 

分 类 号：R575.5[医药卫生—消化系统]