摘要
目的 对精神分裂症伴发非酒精性脂肪肝（NAFLD）患者血清视黄醇结合蛋白4（RBP4）水平进行对照研究,探讨RBP4与NAFLD的关系.方法 测定服用奥氮平的精神分裂症伴NAFLD患者（病例组,n=60）和不伴NAFLD患者（对照组,n=60）血清RBP4、及代谢综合征组分包括体质量指数（BMI）、腰臀比（WHR）、空腹血糖（FPG）、胆固醇（TC）及甘油三酯（TG）、血压;以TyG指数评价胰岛素抵抗;肝/脾CT比值诊断及评估NAFLD严重程度.结果 病例组RBP4水平较对照组增高[（70±13） mg/L vs（52±12） mg/L,t=4.943,P＜0.01）,调整影响因素后差异仍有统计学意义（F=16.797,P＜0.01）;TyG指数、BMI、WHR、FPG、TC、TG、舒张压也高于对照组,差异有统计学意义（t=2.383～4.300,P＜0.05或0.01）.重、中度NAFLD患者RBP4水平高于轻度患者,差异有统计学意义[（79±16）mg/L、（72±8） mg/L vs（63±9） mg/L,d=16.2,9.9,P＜0.01或0.05];病例组RBP4水平与肝/脾CT比值负相关（r=-0.244,P＜0.05）,与TyG指数、BMI、WHR、TG正相关（r=0.197～ 0.244,均P＜0.05）;调整影响因素后,RBP4水平与肝/脾CT比值仍呈负相关（r=-0.453,P＜0.01）.Logistic回归分析示RBP4水平增高与NAFLD发生有关（β=0.105,P＜0.01）,TyG指数增高、血脂异常、肥胖症、中心性肥胖、血压增高也与NAFLD有关（β=1.288～9.711,P＜0.05或0.01）.结论 血清RBP4水平升高可能是精神分裂症患者发生NAFLD的危险因素之一.
Objective To investigate the serum retinol-binding protein 4 （RBP4） level in olanzapinetreated schizophrenia with non-alcoholic fatty liver disease （NAFLD） via a case-control study and to explore its relationship with NAFLD.Methods Schizophrenia receiving olanzapine treatment,with or without NAFLD were enrolled as cases （n=60） or controls （n=60）.The serum retinol-binding protein 4,metabolic syndrome component including body mass index （BMI）,waist-to-hip ratio （WHR）,fasting plasma glucose （FPG）,total cholesterol （TG）,total glycerin （TC） and blood pressure were assayed.TyG index,CT value ratio of liver and spleen were used for insulin resistance or NAFLD diagnosis and severity assessment respectively.Results The serum level of RBP4 was significantly higher in cases than that in controls （（70± 13）mg/L vs （52±12）mg/L ; t =4.943,P〈0.01） and the same result was showed after influencing factor adjustment thru covariance analysis （F=16.797,P〈0.01）.Moreover,cases had significantly higher TyG index,BMI,WHR,FPG,TG and systolic pressure （t=2.383-4.300,P〈0.05-0.01）.Cases with severe or moderate NAFLD had significantly elevated serum RBP4 level compared with mild cases（（79± 16） mg/L,（72±8） mg/L vs （63t9） mg/L,d =16.2,9.9 ; P〈0.01,0.05）.A significantly negative correlation between RBP4 level and the CT value ratio of liver and spleen （r=-0.244,P〈0.05）,and a significantly positive correlation between RBP4 level and TyG index,BMI,WHR,TG（r=0.197-0.244,all P〈0.05） were observed.The partial coefficient between RBP4 level and CT value of liver and spleen was significant with influence adjusted（r=-0.453,P〈0.01）.Logistic regression showed that serum RBP4 level（β3=0.105,P〈0.01）and TyG index,hyperlipidemia,obesity,central obesity or high blood pressure （β =1.288-9.711,P〈 0.05-0.01） were closely associated with NAFLD.Conclusion A heighten serum RBP4 level may be one of NAFLD risk factors in schizophrenia treated with olanzapine.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2014年第12期1095-1098,共4页
Chinese Journal of Behavioral Medicine and Brain Science
