發(fā)布時間：2019-01-12 07:52

【摘要】：目的探討非酒精性脂肪肝(NAFLD)患者血漿成纖維細胞生長因子(FGF)21水平與肥胖、脂代謝及胰島素抵抗(IR)的相關性。方法選擇2012年7月至2015年7月該院收治的NAFLD患者132例,根據(jù)患者是否合并2型糖尿病(T2DM)分為T2DM合并脂肪肝組(DFI組)與單純脂肪肝組(FI組),另選擇同期該院健康體檢者60例為對照組,采用酶聯(lián)免疫吸附法測定血漿FGF21水平,并檢測其各項生理、生化指標,分析FGF21水平與肥胖、脂代謝及IR的相關性。結果 DFI組與FI組患者肥胖比例、體質(zhì)量指數(shù)(BMI)、腰臀比(WHR)、總膽固醇(TC)、甘油三酯(TG)、低密度脂蛋白膽固醇(LDL-C)及游離脂肪酸(FFA)水平均顯著高于對照組,高密度脂蛋白膽固醇(HDL-C)水平顯著低于對照組,DFI組患者BMI、WHR水平顯著低于FI組,TG、空腹胰島素(FINS)水平顯著高于對照組(P0.05);DFI組與FI組患者空腹血糖(FPG)、IR指數(shù)(HOMA-IR)、FGF21水平均顯著高于對照組,DFI組FPG、FNS、HAMO-IR水平顯著高于FI組,FPG顯著高于對照組,DFI組與FI組胰島素敏感指數(shù)(ISI)水平均顯對于對照組,DFI組ISI水平顯著低于FI組(P0.05);研究對象血漿FGF21水平與BMI、HOMA-IR、WHR、FFA、TG呈正相關(r=0.261、0.322、0.341、0.310、0.301,P0.05),與ISI、HDL呈負相關(r=-0.215、-0.281,P0.05);多重線性回歸分析顯示,WHR、HOMA-IR及TG對機體血漿FGF21水平存在顯著影響,且WHR對患者血漿FGF21水平的影響作用最大。結論 NAFLD患者血漿FGF21水平出現(xiàn)顯著升高,機體FGF21水平與肥胖、脂代謝紊亂及IR相關,WHR、HOMA-IR及TG對機體血漿FGF21水平存在顯著影響。
[Abstract]:Objective to investigate the relationship between plasma fibroblast growth factor (FGF) 21) levels and obesity, lipid metabolism and insulin resistance (IR) in patients with non alcoholic fatty liver (NAFLD). Methods 132 patients with NAFLD admitted from July 2012 to July 2015 were divided into T2DM with fatty liver group (DFI group) and simple fatty liver group (FI group) according to whether the patients were complicated with type 2 diabetes mellitus (T2DM). In addition, 60 healthy persons in the same period were selected as the control group. The plasma FGF21 levels were measured by enzyme-linked immunosorbent assay (Elisa), and their physiological and biochemical indexes were determined. The correlation between FGF21 level and obesity, lipid metabolism and IR was analyzed. Results the obesity ratio and body mass index (BMI),) of DFI group and FI group were higher than that of (WHR), group. Total cholesterol (TC), triglyceride (TG), The levels of low density lipoprotein cholesterol (LDL-C) and free fatty acid (FFA) were significantly higher than those of control group, high density lipoprotein cholesterol (HDL-C) level was significantly lower than that of control group, BMI,WHR level in DFI group was significantly lower than that in FI group, and TG, level was significantly lower in DFI group. Fasting insulin (FINS) level was significantly higher than that of control group (P0.05). The fasting blood glucose (FPG), IR index (HOMA-IR) and FGF21 level in DFI group and FI group were significantly higher than those in control group. The FPG,FNS,HAMO-IR level and FPG level in DFI group were significantly higher than those in FI group, and FPG level in DFI group was significantly higher than that in control group. The level of insulin sensitivity index (ISI) in DFI group and FI group was significantly lower than that in FI group (P0.05), and the ISI level in DFI group was significantly lower than that in FI group (P0.05). The plasma FGF21 level was positively correlated with BMI,HOMA-IR,WHR,FFA,TG (r = 0.261) and negatively correlated with ISI,HDL (P < 0.05). Multiple linear regression analysis showed that WHR,HOMA-IR and TG had significant effects on plasma FGF21 level, and WHR had the greatest effect on plasma FGF21 level. Conclusion the plasma FGF21 level was significantly increased in NAFLD patients, and the level of FGF21 was correlated with obesity, lipid metabolism disorder and IR. WHR,HOMA-IR and TG had a significant effect on the plasma FGF21 level.
【作者單位】： 河北大學附屬醫(yī)院消化內(nèi)科;河北大學附屬醫(yī)院貴賓病房;河北省第七人民醫(yī)院骨科;河北北方學院第一臨床學院;
【分類號】：R575.5

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