非酒精性脂肪性肝病患者血清增食欲素A水平变化及其与胰岛素抵抗的关系

摘要

Objective To investigate the changes of the level of serum orexin A in nonalcoholic fatty liver dis-ease(NAFLD)patients and the relationship between orexin A and insulin resistance. Methods Body mass index(BMI) and waist-hip ratio (WHR) of 103 patients with NAFLD and of 99 individuals having general physical examination were measured. Fast blood glucose(FBG) and fast insulin(FINS) were determined for calculating the insulin resis-tance index(HOMA-IR). The level of serum orexin A was detected by ELISA. The relationship of serum orexin A with insulin resistance was statistically analyzed. Results Compared with healthy control group, the BMI, WHR, HOMA-IR, and the levels of serum total cholesterol, triacylglycerol, free fatty acid were significantly higher (P<0.05), but the levels of serum high density lipoprotein cholesterol(HDL-C) and orexin A were significantly decreased (P<0.01, P<0.05). The level of serum orexin A was negatively correlated with BMI, WHR, triacylglcerol, free fatty acid, and HOMA-IR (r=-0.689, -0.741, -0.438, -0.377, -0.611; P<0.01), but the level of serum orexin A was posi tively correlated with HDL-C(r=0.832, P<0.01). Conclusions Lipid metabolism disorder and insulin resistance were observed in NAFLD patients; orexin A may play an important role in occurrence and development of NAFLD by modulating insulin resistance.%目的：观察非酒精性脂肪性肝病（NAFLD）患者血清增食欲素A（Orexin A）水平变化及其与胰岛素抵抗的关系。方法测定103例非酒精性脂肪性肝病患者及99名健康体检者的体质指数（BMI）及腰臀比（WHR），采用酶联免疫吸附试验法检测其血清增食欲素A、血脂、空腹胰岛素及空腹血糖值，计算胰岛素抵抗指数，分析血清增食欲素A水平与胰岛素抵抗的关系。结果与健康对照组比较，NAFLD患者BMI、WHR、HOMA-IR及血清TC、TG、FFA水平均明显增高（P约0.05，P<0.01）；血清HDL-C及Orexin A水平则显著降低（P约0.05）；Orexin A与BMI、WHR、TG、FFA、HOMA-IR均呈明显负相关（r分别为原0.689、原0.741、原0.438、原0.377、原0.611，P约0.01）；与TC无明显相关性；Orexin A与HDL-C呈明显正相关（r=0.832，P约0.01）。结论非酒精性脂肪性肝病患者存在脂代谢异常及胰岛素抵抗，Orexin A可能通过调控胰岛素抵抗参与NAFLD的发生发展。