糖调节异常合并非酒精性脂肪性肝病患者血内皮素-1与胰岛素抵抗的相关性研究  

Correlation between plasma endothlin-1 level and insulin resistance in impaired glucose regulation patients with nonalcoholic fatty liver disease

作　　者：褚韦韦 官莉莉[2] 黄迪华[2] 任跃忠[3] CHU Weiwei;GUAN Lili;HUANG Dihua(Department of Cadre Health Care Center,Shaoxing People's Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院干部保健中心,312000 [2]绍兴市人民医院内分泌及代谢病科,312000 [3]浙江大学医学院附属第二医院内分泌及代谢病科

出　　处：《浙江医学》2018年第6期600-602,626,共4页Zhejiang Medical Journal

基　　金：浙江省医学会临床科研资金项目(2010ZYC-B08)

摘　　要：目的探讨糖调节异常合并非酒精性脂肪性肝病(NAFLD)患者的血内皮素-1(ET-1)与胰岛素抵抗(IR)的相关性。方法将92例患者根据是否合并NAFLD分为单纯糖调节异常组(A组)58例和糖调节异常合并NAFLD组(B组)34例,分别测定两组患者身高、体重、收缩压(SBP)、舒张压(DBP),抽空腹血检查ET-1、空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2h血糖(PBG)、糖化血红蛋白(Hb A1C)、TC、TG、HDL-C、LDL-C、ALT、AST、谷氨酰转肽酶(GGT)。并计算BMI、胰岛素抵抗指数(HOMA-IR)、胰岛素作用指数(IAI)及定量胰岛素敏感性指数(QUICKI)。对两组上述检测指标进行比较并作相关性分析。结果 B组的体重、BMI、FINS、HOMA-IR、ET-1、SBP、DBP、ALT、AST、TG、HDL-C均明显高于A组(均P<0.05),IAI、QUICKI明显低于A组(P<0.05)。两组间Hb A1C、FPG、PBG、TC、LDL-C、GGT差异均无统计学意义(均P>0.05)。Pearson相关分析结果显示,ET-1与体重、BMI、FINS、HOMA-IR呈正相关(P<0.01),与IAI、QUICKI呈负相关(P<0.01)。结论糖调节异常合并NAFLD患者血ET-1水平升高,IR程度明显加重。因此,糖调节异常合并NAFLD患者更需及早进行内皮功能障碍与IR干预,防治糖尿病和心脑血管终点事件的发生。Objective To investigate the correlation between plasma endothlin-1 level and insulin resistance in impaired glucose regulation(IGR)patients with nonalcoholic fatty liver disease(NAFLD).Methods Ninety two IGR patient were enrolled in the study,including 58 patients without NAFLD(group A),and 34 patients with NAFLD(group B).The height,weight,systolic pressure(SBP),diastolic pressure(DBP),plasma endothin-1(ET-1),fasting plasma glucose(FPG),postgrandial 2-hour plasma glucose(PBG),fasting insulin(FINS),glycated hemoglobin(HbA1-c),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),alanine aminotransferase(ALT),aspartic aminotransferase(AST)andγ-glutamyltransferase(GGT)were measured.Body mass index(BMI),index of insulin resistance(HOMA-IR),insulin action index(IAI)and quantitative insulin sensitivity check index(QUICKI)were calculated.Results The weight,BMI,FINS,HOMAIR,ET-1,SBP,DBP,ALT,AST,GGT levels in group B were significantly higher than those in groupA(all P<0.05).And the level of IAI,QUICKI in group B was significantly lower than those in group A(P<0.05).The Pearson's correlation analysis showed that the level of ET-1 was positively correlated with weight,BMI,FINS,HOMA-IR(P<0.01),and was negatively correlated with IAI,QUICKI(P<0.01).Conclusion The IGR patients with NAFLD show an increased ET-1 level and more severity of insulin resistance,indicating that these patients need early intervention for endothelial dysfunction and insulin resistance to prevent the atherosclerosis.

关 键 词：糖调节异常 非酒精性脂肪性肝病 内皮素-1 胰岛素抵抗 

分 类 号：R575.5[医药卫生—消化系统]