Pilot study correlating tumor necrosis factor-α, adiponectin and insulin resistance in patients with non-alcoholic fatty liver
- Author:
- No author available
- Journal Title:
- WORLD CHINESE JOURNAL OF DIGESTOLOGY
- Issue:
- 24
- DOI:
- 10.3969/j.issn.1009-3079.2007.24.010
- Key Word:
- 非酒精性脂肪肝;肿瘤坏死因子-α;脂联素;胰岛素抵抗
Abstract： 目的:探讨非酒精性脂肪肝(NAFLD)患者肿瘤坏死因子-α脂联素水平与胰岛素抵抗等指标的相互关系.方法:120例NAFLD患者根据空腹血糖水平分为合并2型糖尿病(T2DM)者32例(DFL组),不伴T2DM者88例(FL组),所有NAFLD患者根据B超结果分为轻度、中度、重度3组.测定NAFLD患者及42例健康对照者的体质量指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素(FINS)、肿瘤坏死因子-α(TNF-α)、脂联素(APN)水平;采用稳态模式计算胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性指数(ISI)、反应胰岛β细胞分泌功能的指标(HOMA-IS)等指标.结果:NAFLD患者的FINS,HOMA-IR均显著升高,ISI显著低于NC组(P＜0.01);FPG,FINS,ISI,HOMA-IS是IR抵抗的主要相关因素;DFL组的FINS,HOMA-IR较FL组为高,ISI,HOMA-IS较FL组为低,均有显著性差异(P＜0.01);NAFLD患者轻、中度两组间HOMA-IR无显著差异(P＞0.05),而重度脂肪肝患者的HOMA-IR明显升高(P＜0.01).NAFLD患者血清TNF-α显著升高,APN显著降低(P＜0.01);APN与TNF-α,IR呈显著负相关,与ISI呈显著正相关;TNF-α是影响APN水平的重要因素;TNF-α与APN,ISI呈显著负相关,与FPG,FINS,IR呈显著正相关,ISI,APN是其主要的影响因素.结论:NAFLD患者普遍存在IR,合并2型糖尿病的NAFLD患者体内胰岛素抵抗现象更为明显;TNF-α与APN呈显著负相关,且均与IR密切相关.APN作为保护性因子而TNF-α作为损害性因子在NAFLD的发生、发展中起着重要作用.
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