Objective: To investigate the relationship between serum free fatty acid (FFA) and high sensitive C re⁃active protein (hs-CRP),tumor necrosis factor α (TNF-α),and insulin resistance in patients with non-diabetic chronic kidney disease (CKD). Methods: Serum FFA,fasting insulin (FINS),fasting plasma glucose (FPS), hs-CRP, TNF-α, and the lipid profile were measured and compared between 118 patients with non-diabetic CKD (non-dialytic 80 patients and dialytic 38 patients)and 50 normal controls. Insulin resistance was evaluated by using insulin sensitivity index and homeostasis model assessment-insulin resistance index(Homa-IR). Results:Serum FFA, hs-CRP, TNF-α,Homa-IR, triglyceride and lipoprotein(α) were significantly higher in non-diabetic CKD patients compared to those in normal controls (P<0.05 or P<0.01). The increase of serum FFA,hs-CRP, TNF-α,FINS, Homa-IR,triglyceride and lipoprotein(α) were higher in dialytic patients than those in non-dialyt⁃ic patients (P<0.05 or P<0.01). In all patients,FFA was positively correlated with hs-CRP, TNF-α, FINS, Homa-IR, triglyceride and lipoprotein(α) but was negatively related to insulin sensitivity index (P<0.01). Conclu⁃sion: Serum FFA significantly increased in non-diabetic CKD patients and was closely correlated with insulin re⁃sistance.% 目的:观察非糖尿病慢性肾脏病(CKD)患者血清游离脂肪酸(FFA)水平及其与高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、胰岛素抵抗的关系.方法:测定118例非糖尿病CKD患者(非透析治疗80例,血液透析38例)及50名健康人FFA、空腹胰岛素(FINS)、空腹血糖(FPS),同时检测 hs-CRP、TNF-α、血脂等指标,并计算胰岛素敏感指数(ISI)、稳态模型胰岛素抵抗指数(Homa-IR),分析 FFA 与胰岛素抵抗的关系.结果:非糖尿病非透析和透析 CKD 患者血清 FFA、hs-CRP、TNF-α、Homa-IR、TG和LP(α)水平均较健康对照组显著升高(P<0.05或P<0.01),且透析CKD组FFA、hs-CRP、TNF-α、FINS、Homa-IR、TG和 LP(α)水平较非透析CKD组明显升高(P<0.05或 P<0.01);血 FFA 水平与 hs-CRP、TNF-α、FINS、Homa-IR、TG 和 LP(α)呈正相关(P<0.01),与 ISI负相关(P<0.01).结论:非糖尿病CKD患者FFA水平明显升高,且与hs-CRP、TNF-α及胰岛素抵抗密切相关.
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