成人非酒精性脂肪肝患者早期肾损伤状况及影响因素分析  

Analysis of early renal injury status and influencing factors of adult non-alcoholic fatty liver patients

作　　者：任习芳[1] 张祎[1] REN Xifang;ZHANG Yi(Department of Gastroenterology,People＇s Hospital of China Three Gorges University,Wuhan,Hubei 443000,China)

机构地区：[1]三峡大学人民医院消化内科,武汉443000

出　　处：《检验医学与临床》2018年第18期2733-2735,2739,共4页Laboratory Medicine and Clinic

基　　金：湖北省宜昌市科学研究与开发项目卫生课题(A13301-29)

摘　　要：目的研究成人非酒精性脂肪性肝病(NAFLD)患者的早期损伤状况及其与早期肾损伤之间的关系和影响因素。方法根据诊断标准分成NAFLD组(n=78)、NAFLD合并代谢综合征(NAFLD+MS)组(n=47)、对照组(n=78)。对3组进行肝脏生化、肾脏生化及早期肾损伤指标检测,并计算肾小球的滤过率(eGFR)、胰岛素抵抗指数(HOMA-IR)。结果 NAFLD组、NAFLD+MS组与对照组比较,尿微量清蛋白/肌酐(ACR)、β2微球蛋白(β2-MG)、eGFR及HOMA-IR差异有统计学意义(P<0.05)。相关分析表明ACR与体质量指数、腰围、空腹血糖、空腹胰岛素、胆固醇、三酰甘油、低密度脂蛋白、HOMA-IR呈正相关,其中HOMAIR对ACR的影响最大。结论 NAFLD及NAFLD+MS患者存在早期肾损伤,ACR和HOMA-IR是较Scr、eGFR、β2-MG更敏感检测早期肾脏损伤的指标。Objective To evaluate the early renal injury of adult non-alcoholic fatty liver disease（NAFLD）and explore the relationship between NAFLD and early renal injury.Methods According to the diagnostic criteria,it was divided into NAFLD group,NAFLD＋MS group,and control group S0 group.Routine liver biochemistry,renal biochemical and early renal injury index detection,and the calculation of glomerular filtration rate（eGFR）,insulin resistance index（HOMA-IR）.Results The NAFLD group,NAFLD＋ MS group and control group were compared.There were statistical differences among urinary trace albumin/creatinine（ACR）,β2 microglobulin（β2-MG）,glomerular filtration rate（eGFR）and insulin resistance index（HOMAIR）（P〈0.05）.Correlation analysis of ACR and body mass index,waist circumference,fasting glucose,fasting insulin,cholesterol,triglyceride,low density lipoprotein,insulin resistance index were positively correlated,which had the greatest influence of ACR HOMA-IR.Conclusion Patients with NAFLD and NAFLD＋MS are existing early renal damage.Compared with Scr,eGFR,andβ2-MG,ACR and HOMA-IR are more sensitive to early kidney damage index.NAFLD is not only the mark of early kidney damage,but also the early state of chronic kidney disease.

关 键 词：非酒精性脂肪性肝病 代谢综合征 单纯性肥胖 尿微量清蛋白/肌酐 胰岛素抵抗指数 

分 类 号：R320.24[医药卫生—人体解剖和组织胚胎学]