NAFLD儿童瘦素与脂联素检测的临床意义研究

摘要

目的：探讨肥胖儿童非酒精性脂肪性肝病（ NAFLD）患者瘦素（ LEP）、脂联素（ ADPN）的临床意义。方法对符合非酒精性脂肪性肝炎（ NASH）诊断的50例患儿、单纯性脂肪肝（ SFL）的50例患儿及50例正常儿童分别检测血谷丙转氨酶（ALT）、甘油三酯（TG）、总胆固醇（TC）、游离脂肪酸（FFA）、LEP、ADPN、身体质量指数（BMI），比较其水平并分析ALT与各指标的关系。结果 NASH组和SFL组的BMI、TG、TC、FFA、LEP明显高于正常对照组（NASH组与正常组比较：t值分别为2．424、2．636、3．212、3．280、2．535，均P＜0．05；SFL组与正常组比较：t值分别为2．353、2．487、3．545、3．185、2．870，均P＜0．05）；NASH组和SFL组的ADPN明显低于正常对照组（t值分别为-0．294、-0．342，均P＜0．05）。 NASH组BMI、TG、FFA、LEP较SFL组升高（t值分别为2．132、2．488、2．590、3．759，均P＜0．05），NASH组ADPN较SFL组降低（t＝-0．291，P＜0．05）。相关分析显示NAFLD患儿ALT与BMI、TG、TC、FFA、LEP呈正相关（r值分别为0．428、0．317、0．366、0．402、0．338，均P＜0．05），与ADPN呈负相关（r＝-0．223，P＜0．05）。结论 NAFLD患儿存在高脂血症、高瘦素血症和低脂联素血症，随着NAFLD程度的加重，LEP升高和ADPN降低更明显。%Objective To explore the clinical significance of leptin ( LEP) and adiponectin ( ADPN) in obese children with nonalcoholic fatty liver disease (NAFLD).Methods Serum levels of ALT, triglyceride (TG), total cholesterol (TC), free fatty acid (FFA), LEP, ADPN and body mass index ( BMI) were assayed in 50 children with nonalcoholic steatohepatitis ( NASH) , 50 children with simple fatty liver ( SFL) and 50 normal children.The correlation of plasma ALT with TG, TC, FFA, LEP and ADPN was analyzed.Results Children with NASH and SFL had higher BMI, TG, TC, FFA and LEP than the controls ( tNASH value was 2.424, 2.636, 3.212, 3.280 and 2.535, respectively, all P<0.05; tSFL value was 2.353, 2.487, 3.545, 3.185 and 2.870, respectively, all P<0.05).However, ADPN level was significantly lower in NASH and SFL groups than in control group (t value was -0.294 and -0.342, respectively, both P<0.05).NASH children had higher BMI, TG, FFA and LEP compared with SFL children (t value was 2.132, 2.488, 2.590 and 3.759, respectively, all P<0.05), but they had lower level of ADPN (t=-0.291,P<0.05).Correlation analysis revealed that ALT level was positively correlated with BMI, TG, TC, FFA and LEP levels ( r value was 0.428, 0.317, 0.366, 0.402 and 0.338, respectively, all P<0.05), but negatively with ADPN level in NAFLD children (r=-0.223, P<0.05).Conclusion Hyperlipidemia, hyperleptinemia and hypoadiponectinemia exist in NAFLD children.With the increasing of NAFLD degree, LEP level elevates and ADPN level decreases more significantly.