非酒精性脂肪性肝病患者葡萄糖代谢率与血清炎症指标变化的关系  

The Variation of Inflammation Indicator Levels and Its Relationship with Glucose Metabolic Rate in Patients with Non-alcoholic Fatty Disease

作　　者：余启馨 叶建红[2] 林旋[2] 王家乐 何东盈 劳美铃[2] YU Qi-xin;YE Jian-hong;LIN Xuan(Guangzhou University of Chinese Medicine,Guangzhou 510405,China;不详)

机构地区：[1]广州中医药大学,广东广州510405 [2]佛山市中医院内分泌科,广东佛山528000

出　　处：《中国实验诊断学》2020年第6期915-918,共4页Chinese Journal of Laboratory Diagnosis

基　　金：佛山市科技公关项目(编号:2017AB002721)

摘　　要：目的采用高胰岛素正常血糖钳夹技术,检测非酒精性脂肪性肝病(NAFLD)患者的葡萄糖代谢率(M),探讨NAFLD患者胰岛素抵抗与血清超敏-C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化的关系。方法筛选年龄在32-60岁的NAFLD患者30例,并选择同期30例健康者作为对照组。所有受试者均进行高胰岛素-正常血糖钳夹试验,检测M;检测血清hs-CRP、IL-6、TNF-α等炎症因子水平及空腹胰岛素、血糖、血脂,肝功能等生化指标。采用Pearson相关分析法进行M与hs-CRP、IL-6、TNF-α水平的相关性分析。结果①NAFLD组与对照组血清hs-CRP、IL-6和TNF-α水平分别为2.11(1.14-4.24)mg/L vs 0.87(0.15-2.13)mg/L,1.89(1.17-3.39)pg/mL vs 1.26(0.75-1.97)pg/mL以及2.14(1.15-2.87)pg/mL vs 1.42(1.18-2.38)pg/mL,NAFLD组hsCRP、IL-6和TNF-α水平均高于对照组,差异有统计学意义(P<0.01)。②高胰岛素-正常血糖钳夹实验中,稳态时(120-150min)对照组和NAFLD组的M分别为(8.65±1.63)mg·kg-1·min-1和(4.72±1.37)mg·kg-1·min-1,NAFLD组的M明显低于对照组(P<0.01)。③在NAFLD组,与M相关的临床指标有WC、BMI、TG、HDL-C、FINS,r值分别为-0.483、-0.449、-0.565、0.433、-0.578,P分别为0.005、0.012、0.001、0.015、0.001,IL-6、hsCRP及TNF-α均与M呈负相关(r=-0.563、-0.580、-0.598,P=0.001、0.001、0.001)。结论 NAFLD患者的胰岛素抵抗可能与血清hs-CRP、IL-6及TNF-α水平升高有关。Objective To investigate the variations of glucose metabolic rate(M)and levels of serum inflammation marker including hs-CRP,TNF-αand IL-6 from patients with non-alcoholic fatty liver disease(NAFLD).And to investigate the relationship between insulin resistance and levels of serum hs-CRP,TNF-αand IL-6.Methods A total of 30 NAFLD patients aged 32-60 years old were selected as NAFLD group.And 30 normal adults were selected as control group.M was evaluated by hyperinsulinemic euglycemia clamp technique.The serum concentrations of hs-CRP,TNF-α,IL-6 and fasting insulin,blood glucose,blood lipid,liver function were measured.Pearson′s correlation analysis was used to invesgeted the relationship between hs-CRP,TNF-α,IL-6 and M.Results①Serum of hs-CRP,IL-6 and TNF-αin NAFLD group was significantly higher than that in control 2.11(1.14-4.24)mg/L vs 0.87(0.15-2.13)mg/L,1.89(1.17-3.39)pg/mL vs 1.26(0.75-1.97)pg/mL,2.14(1.15-2.87)pg/mL vs 1.42(1.18-2.38)pg/mL,respectively P<0.01 for all).②During the steady state(120-150 min)in the hyperinsulinemic euglycemia clamp test,M in NAFLD group was significantly lower than that in control.(8.65±1.63 mg·kg-1·min-1 vs 4.72±1.37 mg·kg-1·min-1,respectively P<0.01).③In NAFLD group,M was associated with WC,BMI,TG,HDL-C,FINS,r=-0.483,-0.449,-0.565,0.433,-0.578,P=0.005,0.012,0.001,0.015,0.001,IL-6,hs-CRP and TNF-αwere inversely associated with M(r=-0.563、-0.580、-0.598,P=0.001、0.001、0.001).Conclusion Our findings suggested that increased insulin resistance in patients with NAFLD was probably associated with increased serum levels of hs-CRP,TNF-αand IL-6.

关 键 词：非酒精性脂肪性肝病 葡萄糖代谢率 胰岛素抵抗 HS-CRP IL-6 TNF-α 

分 类 号：R575[医药卫生—消化系统]