单纯性肥胖患者血清铁蛋白水平与胰岛素抵抗、脂肪肝发生率的相关性研究  

Relationship between insulin resistance,incidence of fatty liver and serum ferritin level in adults with simple obesity

作　　者：钟祥旭[1] 郑青[1] 李国栋[1] 符先先[1] 王永卿[1] 杨瑶[1] 

机构地区：[1]海口市人民医院检验科,,海南省海口570208

出　　处：《中国基层医药》2015年第23期3566-3569,I0004,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：分析单纯性肥胖患者血清铁蛋白（SF）水平与脂肪肝发生率、胰岛素抵抗（IR）的关联性。方法入选单纯性肥胖患者78例，其中Ⅰ度肥胖34例，Ⅱ度肥胖30例，Ⅲ度肥胖14例。另选单纯性超重成年人35例，健康成年人67例做为对照组。所有受试者均测定身高、体质量、臀围、腰围、SF、血脂、空腹胰岛素（FIN）、空腹血糖（FBG）水平，B 超确诊脂肪肝，计算脂肪肝发生率、胰岛素抵抗指数（HOMA-IR）、体质量指数（BMI）及腰臀比（WHR）。结果随着 BMI 的升高，受试者 SF、FBG、FIN、HOMA-IR、TG、TC、LDL-C 水平亦逐渐上升（F ＝378．92、112．01、55．50、123．96、90．09、127．65、23．81，均 P ＜0．01）、HDL-C 水平则逐渐下降（F ＝114．56，P ＜0．01）；脂肪肝发生率Ⅰ度肥胖组＜Ⅱ度肥胖组＜Ⅲ度肥胖组，差异均有统计学意义（t ＝24.872、7.885，均 P ＜0．01），SF 水平和四分位间距脂肪肝组显著大于非脂肪肝组，差异有统计学意义（t ＝22.99，P ＜0．01）；SF 与 BMI、WRH、FBG、FIN、HOMA-IR、TC、TG、LDL-C 水平呈显著正相关（r ＝0．863、0．719、0．789、0.703、0．617、0．785、0．717、0．771，均 P ＜0．01），与 HDL-C 呈负相关（r ＝－0．530，P ＜0．01）；多因素逐步回归分析提示，影响 HOMA-IR 的独立危险因素是 SF、BMI、FBG、FIN、LDL-C（t ＝6．535、3．254、18．827、61.227、2.154，均 P ＜0．05），影响 SF 的独立危险因素是 BMI、FIN、LDL-C、HOMA-IR（t ＝4．646、2．595、－5．073、6.666，均 P ＜0．01）。结论单纯性肥胖患者存在明显的血脂代谢异常及 IR、易并发脂肪肝，脂肪肝发生率与肥胖严重程度相关，SF 过量表达与其具有密切关联。Objective To explore the relationship of serum ferritin with insluin resistance（IR）and inci-dence of fatty liver in adults with simple obesity.Methods According to body mass index （BMI）,78 adults with simple obesity were divided into three groups,including 34 cases in Ⅰ degree obesity group,30 cases in Ⅱ degree obesity group and 14 cases in Ⅲ degree obesity group,and 35 adults with simple overweight and 67 healthy adults were also enrolled as control group.The height,weight,waistline,hip circumference,incidence of fatty liver,fasting blood glucose （FBG）,fasting insulin （FIN）,blood lipids and ferritin（SF）level were tested,and the body mass index （BMI）,WHR and IR index （HOMA -IR）were calculated.Results When BMI increased,levels of SF,HOMA -IR, FBG,FIN,triglyceride （TG）,cholesterol （TC）,low density lipoprotein -cholesterol （LDL -C）were gradually increased（F =378.92,12.01,55.50,123.96,90.09,127.65,23.81,all P〈0.01）.However,high density lipopro-tein -cholesterol （HDL -C）was gradually degraded（F =114.56,P〈0.01）.The incidence of fatty liver had signifi-cant differences in Ⅰ,Ⅱ,Ⅲ degree obesity groups（（t =24.872,7.885,all P〈0.01）,and with the degree of obesity increased,the rate of fatty liver increased significantly.SF range interquartile and level in fatty liver group was signifi-cantly greater than the non fatty liver group,the difference was statistically significant （t =22.99,P〈0.01）.SF was positively correlated with BMI,WRH,FBG,FIN,HOMA -IR,TC,TG,LDL -C （r =0.863,0.719,0.789,0.703, 0.617,0.785,0.717,0.771,all P〈0.01）,and negatively correlated with HDL -C（r =-0.530,P〈0.01）.Multi-ple stepwise regression analysis indicated that BMI,FIN,LDL -C,HOMA -IR were independent risk factors affecting SF（t =4.646,2.595,-5.073,6.666,all P〈0.01）.SF,BMI,FBG,FIN,LDL -C were independent risk factors influencing HOMA -IR（t =6.535,3.254,18.827,61.227,2.154,all P〈0.05）.Conclusion Simple obesity adults had obvious blood lipid disorder

关 键 词：肥胖症 铁蛋白 胰岛素抵抗 

分 类 号：R589.2[医药卫生—内分泌] R575.5[医药卫生—内科学]