[目的]研究非酒精性脂肪肝(NAFLD)患者胰岛素抵抗指数(IRI)、瘦素和脂联素水平的变化,探讨疾病发病中胰岛素抵抗(IR)、瘦素和脂联素的作用。[方法]测定体检和住院人群中NAFLD并肥胖(NAFLD)组、单纯性肥胖(肥胖)组和正常对照组空腹血糖、空腹血清胰岛素,采用稳态模型法计算IRI,同时检测瘦素和脂联素水平。[结果]NAFLD组空腹胰岛素水平和IRI显著高于肥胖组和对照组(P<0.05);NAFLD组和肥胖组的瘦素水平显著高于对照组(P<0.05);NAFLD组和肥胖组的脂联素水平显著低于对照组(P<0.05);直线相关分析后,IRI与血清瘦素水平呈显著正相关(r=0.169 3,P<0.01);而与血清脂联素水平呈显著负相关(r=-0.218 7,P<0.01)。[结论]IR可能是NAFLD发生、发展的基础,IR构成NAFLD患者基本特征之一,中央型肥胖是NAFLD的危险因素;NAFLD患者瘦素水平升高而脂联素水平降低,瘦素和脂联素通过不同机制参与了IR的发生、发展,进而影响NAFLD的发病。 [Objective] To investigate the changes of insulin resistance index (IRI), leptin and adiponectin in patients with non-alcoholic fatty liver disease (NAFLD) and explore the role of insulin resistance (IR), leptin and adiponectin in the pathogenesis of NAFLD. [Methods] The fasting blood glucose and fasting serum insulin of NAFLD and obesity (NAFLD) group, simple obesity (obesity) group and normal control group were measured in physical examination and hospitalization group. IRI was calculated by steady-state model. Meanwhile, leptin and adiponectin Su-level. [Results] The levels of fasting insulin and IRI in NAFLD group were significantly higher than those in obesity group and control group (P <0.05); the levels of leptin in NAFLD group and obesity group were significantly higher than those in control group (P <0.05); NAFLD group and obesity group The level of adiponectin was significantly lower than that of the control group (P <0.05). After the linear correlation analysis, there was a significant positive correlation between IRI and serum leptin level (r = 0.169 3, P <0.01) Negative correlation (r = -0.218 7, P <0.01). [Conclusion] IR may be the basis for the occurrence and development of NAFLD. IR constitutes one of the basic characteristics of NAFLD patients. Central obesity is a risk factor for NAFLD. Leptin levels and adiponectin levels are reduced in patients with NAFLD. Through different mechanisms involved in the pathogenesis of IR, development, thereby affecting the incidence of NAFLD.