非酒精性脂肪性肝病患者血清胰腺衍生因子水平及其与胰岛素抵抗的关系  

Level of pancreatic derived factor in serum and its correlation with insulin resistance in patients with non-alcoholic fatty liver disease

作　　者：孙露[1] 赵刚[2] 李红[2] 史海涛[2] 鲁晓岚[2] SUN Lu;ZHAO Gang;LI Hong;SHI Haitao;LU Xiaolan(Department of Ultrasound;Department of Gastroenterology,the Second Affiliated Hospital of Xi＇an Jiaotong University School of Medicine,Xi＇an 710004,China)

机构地区：[1]西安交通大学医学院第二附属医院医用超声研究室,陕西西安710004 [2]西安交通大学医学院第二附属医院消化内科,陕西西安710004

出　　处：《胃肠病学和肝病学杂志》2018年第10期1119-1124,共6页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨血清胰腺衍生因子(pancreatic derived factor,PANDER)在非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者中的水平及其在胰岛素抵抗(insulin resistance,IR)相关代谢性疾病的发生、发展及相互影响中的作用。方法选取单纯NAFLD患者30例、单纯2型糖尿病(T2DM)患者28例、NAFLD合并T2DM患者21例、健康对照者15名。收集体格检查资料,测定肝功、血脂、空腹血糖、FINS、血清FFA、血清PANDER、TNF-α及IL-6浓度。应用SPSS 19. 0进行相关统计学分析。结果 (1)NAFLD患者的血清PANDER水平(72. 33±0. 02)μg/L高于健康对照者(67. 80±0. 02)μg/L,低于T2DM患者(73. 80±0. 02)μg/L,但各组间差异无统计学意义(P>0. 05)。(2) NAFLD、BMI及TG水平是HOMA-IR的主要预测因子,而血清PANDER未进入回归方程(回归方程=NAFLD×0. 551+BMI×0. 040+TG×0. 260-1. 710)。(3) HOMA-IR及血清FFA是血清PANDER水平的主要影响因素(回归方程=HOMA-IR×0. 191+FFA×0. 050-3. 181),但其与BMI、腹围、ALT、LDL、TG、HOMA-IR、血清TNF-α、血清IL-6尚无线性相关。(4)健康人群中,腹型肥胖(腹围)是NAFLD最重要的危险因素;而T2DM患者中,高TG血症是T2DM合并NAFLD最重要的危险因素;但不论是健康人群或T2DM人群,血清PANDER水平升高都不是NAFLD的危险因素。结论血清PANDER水平升高可能不是影响IR及NAFLD发病的危险因素,但IR是血清PANDER水平的影响因素之一。ObjectiveTo evaluate the level of pancreatic derived factor （PANDER） in serum in patients with non-alcoholic fatty liver disease （NAFLD）, and the role of it in the oncome, progression and interaction of the metabolic diseases, which are associated with insulin resistance （IR）.MethodsPatients were collected and divided into 4 groups according to the diagnostic criteria. It included 30 patients in NAFLD group, 28 patients in T2DM group, 21 patients in NAFLD combined with T2DM group and 15 cases in control group. Clinical data were recorded. The indexes of liver function, blood lipid, fasting blood glucose （FBG）, fasting insulin （FINS）, free fat acid （FFA）, PANDER, tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in serum were measured.Results（1） In NAFLD patients, the level of PANDER （72.33±0.02）μg/L in serum was higher than that in healthy controls （67.80±0.02）μg/L, but lower than that in T2DM patients （73.80±0.02）μg/L, but there was no statistically significant difference among each group （ P 〉0.05）. （2） NAFLD, BMI and TG level were the major predictors of HOMA-IR, but PANDER was not included in the regression equation （the regression equation=NAFLD×0.551＋BMI×0.040＋TG×0.260- 1.710 ）. （3） HOMA-IR and serum FFA were the main factors to affect the level of PANDER in serum （the regression equation=HOMA-IR×0.191＋FFA×0.050-3.181）. （4） In healthy controls, abdominal obesity （waist） was the most important risk factor for NAFLD; but in T2DM patients, high TG level was the most important risk factor for NAFLD. However, in both healthy controls and T2DM patients, high level of PANDER in serum was not the risk factor for NAFLD.ConclusionHigh level of PANDER in serum may not contribute to either IR or NAFLD. But IR would be a factor which can affect the level of PANDER in serum.

关 键 词：非酒精性脂肪性肝病 胰岛素抵抗 胰腺衍生因子 

分 类 号：R575.5[医药卫生—消化系统]