非酒精性脂肪肝纤维化评分与胰岛素抵抗的关系

摘要

Objective To investigate the local incidence of impaired glucose regulation ( IRG) and type 2 diabetes mellitus (T2DM) in patients with nonalcoholic fatty liver disease (NAFLD) and analyze the association between nonalco-holic fatty liver disease score ( NAFLDS) and insulin resistance ( IR) .Methods A total of 119 NAFLD patients were enrolled into the current study and underwent screening for dysglycaemia and measurement of IR.Meanwhile, another 21 gender, age-matched health subjects without NAFLD were set as the control.The oral glucose tolerance test ( OGTT) and routine blood test were performed, while blood lipid metabolism and hepatic and renal function were evaluated.Their levels of fasting plasma glucose (FPG) and fasting insulin (FINS) were measured, and the homeostasis model assess-ment-insulin resistance ( HOMA-IR) was assessed.Results The NAFLD group presented remarkably higher HOMA-IR as well as IRG and T2MD incidence than the control (P<0.01).The patients at high-risk of hepatic fibrosis showed markedly higher HOMA-IR than those at low-and medium-risk (P<0.01).Conclusions NAFLD patients show stronger insulin resistance than those without NAFLD.Higher incidence of IGR and T2DM was found in NAFLD pa-tients than those without NDFLD.Patients at high-risk of hepatic fibrosis show stronger IR.%目的：研究非酒精性脂肪性肝病（NAFLD）患者糖尿病前期（IGR）及2型糖尿病（T2DM）的发病情况，分析非酒精性脂肪肝纤维化评分（ NAFLDFS）与胰岛素抵抗的关系。方法对119例NAFLD患者进行糖代谢异常筛查及胰岛素抵抗检测。选取性别、年龄相匹配的21例无NAFLD的健康体检者作为对照。对所有研究者进行口服葡萄糖耐量试验（ OGTT ）及血常规、血脂、肝功能和肾功能检测。同时测量血糖（ FPG ）、胰岛素水平（ FINS），评估胰岛素抵抗指数（ HOMA－IR）。结果 NAFLD组的HOMA－IR 明显高于对照组（ P＜0．01）。NAFLD组的IGR及T2DM发病率明显高于对照组（P＜0．01）。高度肝脏纤维化风险组的HOMA－IR显著高于中、低风险组（均P＜0．01）。结论 NAFLD患者的胰岛素抵抗程度高于非NAFLD患者，NAFLD患者的IGR及T2DM发病率高于非NAFLD患者，高度肝脏纤维化风险者的胰岛素抵抗程度增加。