瘦素、脂联素和胰岛素敏感指数与艾滋病HAART后非酒精性脂肪肝相关性分析

摘要

Objective To explore the association between nonalcoholic fatty liver (NAFLD) after HAART in HIV/ AIDS patients and leptin, adiponectin and insulin sensitivity index ( HOMA-ISI). Methods In this cross-sectional observational study, NAFLD was detected by color Doppler ultrasound in AIDS patients with HAART. Comparison with non-NAFLD patients, and the changes of BMI, CD4 cell levels, fasting blood glucose and lipid levels, insulin levels (FINS) , insulin sensitivity index and resistance index, liver and kidney functions, leptin and adiponectin levels were detected in NAFLD patients after HAART; and independent risk factors with NAFLD were analyzed by logistic regression model. Results In 75 patients with HAART treatment, NAFLD had been found in 25 patients. In logistic regression multivariate regression analysis model, leptin levels ( OR = 2. 88 , P =0. 001 ) and HOMA-ISI (OR = 0.56 , P =0. 004) demonstrated a high degree of correlation with NAFLD, in which HOMA-ISI was a protective factor of NAFLD after HAART. Conclusion In NAFLD patients after HAART Triglycerides and insulin levels, insulin resistance index and leptin levels increased significantly, adiponectin levels and insulin sensitivity index is lower significantly. It was suggested that leptin levels is independent risk factors and HOMA-ISI is a protective factor in NAFLD after HAART.%目的 探讨瘦素、脂联素和胰岛素敏感指数与艾滋病HAART后非酒精性脂肪肝(NAFLD)的相关性.方法 我们利用横断面观察研究,通过彩超检测发现艾滋病HAART后合并NAFLD的患者；这些患者和非NAFLD比较,探讨HAART后合并NAFLD的患者体重指数(BMI)、CD4细胞水平、空腹血糖和血脂水平、胰岛素水平(FINS)、胰岛素敏感指数(HOMA-ISI)和抵抗指数、肝肾功能、瘦素和脂联素的变化；并运用Logistic回归分析HAART后合并NAFLD的独立风险因素.结果 在75例接受HAART患者中,发现25例NAFLD患者；在Logistic回归多变量回归分析模型中,瘦素水平(OR=2.88,P=0.001)和HOMA-ISI(OR =0.56,P=0.004)与脂肪肝的发生具有高度的相关性；其中HOMA-ISI是艾滋病合并NAFLD发生的保护性因素.结论 在艾滋病HAART后NAFLD的患者中,甘油三酯、胰岛素水平、胰岛素抵抗指数、瘦素水平明显增高,脂联素水平和胰岛素敏感指数显著降低；其中瘦素水平是艾滋病HAART后发生NAFLD的预测因素,胰岛素敏感指数为保护性因素.