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采用病例对照研究,2型糖尿病伴有脂肪肝(DF)组33例,2型糖尿病不伴脂肪肝(NDF)组48例,脂肪肝(F)组13例,正常对照(C)组14例。检测4组患者的体脂参数、血脂、并行OGTT以及胰岛素释放试验,采用稳态模型胰岛素抵抗指数(HOMAIR)评价胰岛素抵抗。结果:DF组与NDF组、F组与C组比较,体重指数(BM1)、腰围(W1)、腰臀比(WHR)、胆固醇(TC)、甘油三脂(TG)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、HOMAIR水平明显升高(P<0.05)。F组的空腹血糖、餐后血糖、空腹胰岛素和餐后胰岛素水平高于C组(P<0.05)。结论:脂肪肝患者普遍存在胰岛素抵抗,提示胰岛素抵抗及糖脂代谢异常在脂肪肝的发病机制中具有十分重要的作用。
A case-control study was conducted in 33 patients with type 2 diabetes mellitus (DF), 48 with type 2 diabetes without fatty liver (NDF), 13 with fatty liver (F) and 14 with normal control (Group C) . Body fat parameters, lipids, parallel OGTT and insulin release test were measured in 4 groups. The homeostasis model insulin resistance index (HOMAIR) was used to evaluate insulin resistance. Results: The body mass index (BM1), waist circumference (W1), WHR, TC, triglyceride (TG), alanine aminotransferase The levels of ALT, AST and HOMAIR were significantly increased (P <0.05). The fasting blood glucose, postprandial blood glucose, fasting insulin and postprandial insulin in group F were higher than those in group C (P <0.05). Conclusion: The prevalence of insulin resistance in patients with fatty liver, suggesting that insulin resistance and abnormal glucose and lipid metabolism in the pathogenesis of fatty liver has a very important role.