非肥胖型非酒精性脂肪性肝病患者胰岛素抵抗及胰岛β细胞功能的研究  

Study on Insulin Resistance and Islet β Cell Function in Non-obese Patients with Nonalcoholic Fatty Liver Disease

作　　者：周夫 黄春梅 李素芬 苏彩霞 韦钰蘅 陈燕玲 黄志玲 ZHOU Fu;HUANG Chunmei;LI Sufen;SU Caixia;WEI Yuheng;CHEN Yanling;HUANG Zhiling(The Fourth People’s Hospital of Nanhai District,Foshan 528211,China;不详)

机构地区：[1]广东省佛山市南海区第四人民医院,广东佛山528211

出　　处：《中国医学创新》2020年第33期50-53,共4页Medical Innovation of China

基　　金：佛山市科技局医学类科技攻关项目(2017AB000852)。

摘　　要：目的:探讨非肥胖型非酒精性脂肪性肝病(NAFLD)患者胰岛素抵抗及胰岛β细胞功能。方法:选择2018年1-6月在于本院就诊的非肥胖NAFLD患者32例为NAFLD组,另选取同期于本院体检的健康人32例为对照组。所有研究对象于随访前与随访18个月后均采集体重指数(BMI),行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验(IRT),测量空腹血糖(FPG)、空腹胰岛素(FINS)、糖负荷后30 min的血糖(PG30min)及胰岛素(INS30min),计算稳态模型评估胰岛素抵抗指数(HOMA-IR)、稳态模型评估胰岛β细胞功能指数(HOMA-β)、早相胰岛素分泌指数(early-phase insulin secretion index,ΔI30/ΔG30)。比较随访前后两组HOMA-IR、HOMA-β及ΔI30/ΔG30。结果:NAFLD组BMI、FPG、FINS、PG30min及INS30min均高于对照组(P<0.05)。随访前后,NAFLD组HOMA-IR与ΔI30/ΔG30均高于对照组(P<0.05),而两组HOMA-β比较,差异无统计学意义(P>0.05)。两组随访前后HOMA-IR、HOMA-β及ΔI30/ΔG30均无显著变化,差异均无统计学意义(P>0.05)。结论:非肥胖型NAFLD患者存在胰岛素抵抗,早期胰岛β细胞功能尚未受损。短期内胰岛素抵抗及胰岛功能的变化缓慢。Objective:To investigate insulin resistance and islet β cell function in non-obese patients with nonalcoholic fatty liver disease (NAFLD).Method:A total of 32 non-obese patients with NAFLD patients from January to June 2018 in our hospital were selected as NAFLD group.Another 32 healthy people underwent physical examination in our hospital during the same period were selected as the control group.Before and after 18 months of follow-up,body mass index (BMI) was collected,oral glucose tolerance test (OGTT) and insulin release test (IRT) were performed.Fasting blood glucose (FPG),fasting insulin (FINS),glucose (PG30min) and insulin (INS30min) at 30 min after glucose load were measured.The homeostatis model assessment of insulin resistance index (HOMA-IR),β-cell function index (HOMA-β) and early-phase insulin secretion index(ΔI30/ΔG30)were calculated.HOMA-IR、HOMA-β and ΔI30/ΔG30 were compared between the two groups before and after follow-up.Result:BMI,FPG,FINS,PG30min and INS30min of the NAFLD group were all higher than those of the control group (P<0.05).Before and after follow-up,the HOMA-IR and ΔI30/ΔG30 of the NAFLD group were higher than those of control group (P<0.05),while there was no significant difference in HOMA-β between two groups (P>0.05).The HOMA-IR,HOMA-β and ΔI30/ΔG30 of the two groups before and after follow-up had no significant change,there were no statistically significant difference (P>0.05).Conclusion:Non-obese patients with NAFLD have insulin resistance,and islet β cell function is not impaired in the early stage.Insulin resistance and islet β cell function change slowly in a short time.

关 键 词：非酒精性脂肪性肝病 非肥胖 胰岛素抵抗 胰岛Β细胞功能 早相胰岛素分泌指数 

分 类 号：R575.5[医药卫生—消化系统]