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目的探讨非酒精性肝脏疾病(NAFLD)患者血清白介素-6(IL-6)、白介素-10(IL-10)的水平及其脂代谢以及胰岛素抵抗的情况。方法检测NAFLD组90例和正常对照组18例的血清IL-6、IL-10、丙氨酸氨基转移酶(ALT)、血脂、空腹胰岛素(FINS)和2h胰岛素(2HINS)、游离脂肪酸(FFA),采用稳定模式评价胰岛素抵抗(HOMAIR),并通过CT定量评价两组对象肝脏脂肪含量(HFC)。结果NAFLD组IL6、FFA、ALT水平高于对照组,两组比较有显著差异(P<0.05)。NAFLD组与对照组比较IL10水平低于正常对照组(P<0.05)。NAFLD组与对照组比较腰臀比(WHR)、胆固醇(TC)、甘油三酯(TG)、FINS、2HINS和HOMAIR、HFC水平均明显高于正常对照组(P<0.001)。多元逐步回归分析显示WHR和ALT与HFC呈正相关。结论IL6和IL10在NAFLD的致病机理中有一定的临床价值。NAFLD患者与胰岛素抵抗密切相关,WHR和ALT是影响NAFLD患者HFC独立的危险因素。
Objective To investigate the levels of interleukin-6 (IL-6), interleukin-10 (IL-10) and their lipid metabolism and insulin resistance in patients with non-alcoholic liver disease (NAFLD). Methods Serum levels of IL-6, IL-10, ALT, FINS, 2HINS and FFA in 90 NAFLD patients and 18 normal controls were measured. ). HOMAIR was assessed using a stable model and the hepatic adipose content (HFC) was quantified by CT. Results The levels of IL6, FFA and ALT in NAFLD group were significantly higher than those in control group (P <0.05). The level of IL10 in NAFLD group was lower than that in control group (P <0.05). The WHR, TC, TG, FINS, 2HINS, HOMAIR and HFC in NAFLD group were significantly higher than those in control group (P <0.001). Multiple stepwise regression analysis showed that WHR and ALT were positively correlated with HFC. Conclusion IL6 and IL10 have certain clinical value in the pathogenesis of NAFLD. Patients with NAFLD are closely associated with insulin resistance, and WHR and ALT are risk factors for HFC independence in patients with NAFLD.