非酒精性脂肪性肝病患者血清preptin水平与胰岛素抵抗的相关性分析  

Association between serum preptin level and insulin resistance in patients with nonalcoholic fatty liver disease

作　　者：王锦俊 王芹芹[2] 刘欣艳[1] 李英梅[1] 熊伍军[2] 

机构地区：[1]上海中医药大学附属普陀医院老年科,上海200062 [2]同济大学附属东方医院消化内科,上海200120

出　　处：《临床肝胆病杂志》2016年第9期1774-1777,共4页Journal of Clinical Hepatology

基　　金：上海中医药大学附属普陀医院院级课题资助(2013PT059)

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)患者血清preptin水平的变化及其与胰岛素抵抗(IR)的相关性。方法选取2014年4-8月在上海中医药大学附属普陀医院、同济大学附属东方医院门诊、住院的72例NAFLD患者(NAFLD组),53例年龄、性别匹配的正常对照者(正常对照组)为研究对象。所有受试者进行B超检查,根据B超检查结果将NAFLD组患者分为轻度组(n=20)、中度组(n=30)和重度组(n=22)3个亚组。分别测量身高、体质量、收缩压、舒张压、腰围、臀围、肝功能、血脂、高敏C反应蛋白、空腹血糖、空腹胰岛素(FINS)、糖化血红蛋白、血清preptin水平,并计算BMI、腰臀比及稳态模型胰岛素抵抗指数(HOMAIR)。计量资料两组间均数比较采用两独立样本t检验,多组间比较采用单因素方差分析,进一步两两比较采用SNK-q检验;相关性分析采用Pearson相关系数法;采用多元线性回归分析各变量与preptin之间的关系,采用logistic回归分析各变量与NAFLD之间的关系。结果 NAFLD组preptin水平(385.54±72.78)pg/ml较正常组(303.85±57.54)pg/ml显著升高(t=-6.76,P<0.001);轻度、中度和重度NAFLD组preptin水平逐渐升高,分别为(328.58±53.51)pg/ml﹑(376.71±57.77)pg/ml﹑(449.35±56.95)pg/ml,3组间比较差异有统计学意义(F=3.08,P<0.001)。Pearson相关分析显示血清preptin水平与BMI(r=0.475,P<0.001)、HOMA-IR(r=0.671,P<0.001),FINS(r=0.763,P<0.001)成正相关。多元线性回归分析显示FINS和HOMA-IR是影响血清preptin水平的独立相关因素,logistic回归分析显示preptin与NAFLD密切相关。结论 Preptin与NAFLD的发生密切相关,可能通过影响IR而参与NAFLD的发生发展。Objective To investigate the change in serum preptin level and its association with insulin resistance（ IR） in patients with nonalcoholic fatty liver disease（ NAFLD）. Methods A total of 72 patients with NAFLD who visited the outpatient service or were hospitalized in Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine and Dongfang Hospital Affiliated to Tongji University from April to August,2014 were enrolled,and 53 normal controls（ NCs） matched by age and sex were also enrolled. All the subjects underwent ultrasound examination,and according to the results of ultrasound examination,the patients were divided into mild,moderate,and severe NAFLD groups. The following parameters were measured： body height,body weight,systolic blood pressure,diastolic blood pressure,waist circumference,hip circumference,liver function parameters,blood lipids,high- sensitivity C- reactive protein,fasting blood glucose,fasting insulin（ FINS）,glycosylated hemoglobin,and serum preptin level. Body mass index（ BMI）,waist- hip ratio,and homeostasis model assessment of insulin resistance（ HOMA- IR） were calculated. The two- independent- samples t test was used to compare means of continuous data between groups,comparison between group was made by analysis of variance,and multiple comparisons were made by SNK- q test; and the Pearson correlation coefficient method was used for correlation analysis; a multivariate linear regression analysis was used to identify the the correlations between preptin and variables,and a logistic regression analysis was used to identify the associations between variables and NAFLD. Results The NAFLD patients had a significant increase in the preptin level compared with the control group（ 385. 54 ± 72. 78 pg/ml vs 303. 85 ± 57. 54 pg/ml,t =- 6. 76,P 0. 001）; the mild,moderate,and severe NAFLD groups showed gradual increases and significant differences in the preptin level（ 328. 58 ± 53. 51 pg/ml,376. 71 ± 57. 77 pg/ml,and 449. 35 ± 56. 95 pg/ml,resp

关 键 词：脂肪肝 胰岛素抗药性 肽类激素 

分 类 号：R575.5[医药卫生—消化系统]