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采用病例对照研究。检测正常人、单纯脂肪肝、脂肪肝合并糖耐量低减(IGT)和脂肪肝合并2型糖尿病(DM)四组受试者空腹状态下的脂联素、血脂和肝肾功能,空腹和75gOGTT试验后2h血糖和血清胰岛素。并计算胰岛素敏感性指数(HOMA-SI)、体重指数(BMI)和腰臀比(WHR)。结果:与对照组比较,另三组SI、血清脂联素均依次显著降低(P<0.05);单纯脂肪肝组和脂肪肝并IGT组之间差异均无显著性,但均显著高于脂肪肝并2型DM组(P<0.05)。脂联素与SI呈正相关,而与BMI、WHR、空腹及餐后血糖和胰岛素、甘油三脂(TG)、谷丙转氨酶(ALT)等呈显著负相关。多元逐步回归分析显示血清脂联素与空腹血糖(FBG)、餐后胰岛素(PINS)、WHR、TG具有高度相关性(均P<0.05)。结论:NAFLD患者血清脂联素、SI下降;随着血糖升高进一步降低;血清脂联素与SI呈正相关。
Case-control study. The levels of adiponectin, lipids and liver-kidney function in fasting, fasting and 75gOGTT were measured in four groups of subjects with normal fatty liver, fatty liver with IGT and DM with type 2 diabetes mellitus (DM) 2h after the test blood glucose and serum insulin. The insulin sensitivity index (HOMA-SI), body mass index (BMI) and waist-hip ratio (WHR) were calculated. Results: Compared with the control group, the levels of SI and serum adiponectin decreased significantly (P <0.05), but there was no significant difference between the simple fatty liver group and the fatty liver and IGT group Liver and type 2 DM group (P <0.05). Adiponectin was positively correlated with SI, but negatively correlated with BMI, WHR, fasting and postprandial blood glucose and insulin, triglyceride (TG) and alanine aminotransferase (ALT). Multivariate stepwise regression analysis showed that serum adiponectin was highly correlated with fasting blood glucose (FBG), postprandial insulin (PINS), WHR, TG (all P <0.05). Conclusion: Serum levels of adiponectin and SI are decreased in NAFLD patients, and further decrease with elevated blood glucose. Serum adiponectin is positively correlated with SI.