摘要
目的评价糖调节正常（NGR）而有不同程度非酒精性脂肪肝（NAFLD）患者的β细胞功能与胰岛素敏感性。方法选择19例21～56岁NGR的NAFLD患者作为研究对象。以CT扫描肝脏半定量方法测定他们的肝脏脂肪含量（LF），并根据LF分3组：≤5．0％组（A组：6例）；5．1％～9．9％组（B组：7例）；10．0％～20．0％组（C组：6例）。以高糖钳夹技术评价各组β细胞功能与胰岛素敏感性。结果胰岛素一相分泌曲线下面积3组差异无统计学意义[A、B、C组分别为（2．60±0．12、2．81±0．18、2．70±0．23）min·mU·L^-1]。胰岛素二相分泌曲线下面积3组分别为（4．03±0．29、4．20±0．17、4．41±0．17）min·mU·L^-1，C组明显高于A和B组（均P〈0．05）。胰岛素敏感性指数（ISI）3组分别为（25．14±14．77、8．31±2．24、4．57±2．49，P〈0．05）。多元线性回归分析提示LF是影响ISI最强的独立危险因素。结论在NGR且LF不超过20％的NAFLD患者中，随着LF增加，胰岛素敏感性逐渐下降。LF超过10％时，B细胞功能可能已经受损。
Objective To assess the impact of liver fat content （LF） on D-cell function and insulin sensitivity in subjects with non-alcoholic fatty liver disease （NAFLD） and normal glucose regulation （NGR）. Methods Nineteen subjects aged 21-56 years with NAFLD and NGR, negative HBsAg or HCV-Ab and without history of excessive drinking （ alcohol 〈 40 g/d in males and 〈 20 g/d in females） were admitted. CT scan was applied to judge LF in these subjects. They were divided into 3 groups： LF ≤5.0% （ group A, n = 6 ）, LF 5.1% - 9.9% （group B, n =7） and LF 10.0%-20.0% （group C, n =6）. Hyperglycemic clamp technique was used to assess D-cell function and insulin sensitivity. Results There were no significant differences among groups in age, sex, waist circumference, waist-to-hip ratio, fasting blood glucose, postprandial 2 h blood glucose, total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol. Body mass index and trlglycerides level in group C was higher than those in groups A and B （ all P 〈 0.05 ） while no significant difference was observed between group A and group B. There was no significant difference in the area under first phase insulin release curve （ AUC~ ） among 3 groups [ （2.60 ± 0. 12, 2.81 ± 0. 18, 2.70 ± 0.23 ） min · mU · L^-1, respectively]. Area under second phase insulin release curve （AUC2） of group C （4.41 ± 0. 17 ）min · mU · L^-1 was significantly higher than those of group A （4.03 ± 0.29）min · mU · L^-1 and group B （4.20 ± 0.17） min · mU · L^-1 （ both P 〈 0.05 ）. Insulin sensitivity index （ISI） were 25.14 ± 14.77, 8.31 ± 2.24, 4.57 ± 2.49 in group A, B, C respectively （ P 〈 0.05 ）. Linear regression analysis suggested that LF was the strongest risk factor for ISI. Conclusion Insulin sensitivity is decreased with increasing LF in subjects with NAFLD and NGR when their LF are less than 20%. D-cell function may be impaired in such subjects with LF exceeding 10%.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2007年第1期12-15,共4页
Chinese Journal of Endocrinology and Metabolism
基金
上海市医学发展基金重点研究课题（2001-2004）基金资助项目[编号2001ZD002（3）]
