空腹游离脂肪酸与非酒精性脂肪性肝病及颈动脉内膜中层厚度的关系研究

摘要

Objective To study the relation ship of free fatty acid(FFA)with non-alcoholic fatty liver disease (NAFLD)and carotidintima-media thickness(CIMT).Methods To select 120 patients who conducted health examination in hospital during 2010 May to2012 July as the research object.They were divided into four groups according to fasting FFA quartile and compared.Results (1)Compared with non-NAFLD group,subjects in NAFLD group had significantly higher body mass index,waist circumference,blood pres-sure,fasting plasma glucose,and 2h postprandial glucose,total cholesterol,triglycerides,LDL-C,liver enzymes,fasting insulin,2h post-prandial insulin,homeostasis model assessment for insulin resistance(HOMA-IR),CIMT,fasting and 2h postprandial FFA(all P <0.05),while the level of HDL-C was decreased(P <0.01).(2)Compared with those in the lowest quartiles of fasting FFA,subjects inthe highest quartile had significantly higher level of systolic blood pressure,fasting plasma glucose,2h postprandial glucose,total cho-lesterol,triglycerides,liver enzymes,2h postprandial insulin,2h postprandial FFA(all P <0.05),and frequency of NAFLD was alsoincreased(P <0.01).(3)Logistic regression analysis showed that fasting FFA,HOMA-IR,body mass index,and alanine aminotrans-ferase were independently correlated with NAFLD after adjustment of other parameters(β=0.002,0.263,0.331,0.038,respectively,all P <0.05).Conclusions Fasting FFA was independently and positively associated with NAFLD.CIMT level was higher inpatientswith NAFLD.%目的：研究非酒精性脂肪性肝病（NAFLD）与颈动脉内膜中层厚度（CIMT）及血清游离脂肪酸之间的关系。方法选取自2010年5月到2012年7月期间，在该院接受健康体检的120例体检者为研究对象。并根据空腹FFA水平的四分位点将全部体检者分为Q1～Q4四组，比较各组间临床资料。结果（1）血压、总胆固醇、LDL-C、腰围、肝酶、胰岛素、FFA、HOMA-IR、血糖、体重指数、甘油三酯和CIMT水平显著升高（均P＜O．05），而HDL-C则降低（P＜0．01）。（2）Q1组总胆固醇、收缩压、肝酶、餐后2 h胰岛素和FFA、血糖、甘油三酯水平及NAFLD的频率均显著高于Q1组，而HDL-C含量则有明显的下降（均P＜0．05）。（3）结果表明ALT、HOMA-IR、空腹FFA和体重指数为 NAFLD的独立影响因素（β值分别为0．263、0．002、0．331、0．038，均P＜0．05）。结论空腹游离脂肪酸水平同NAFLD独立相关，且NAFLD患者的CIMT显著增厚。