摘要
目的探讨儿童非酒精性脂肪肝(NAFLD)发病与胰岛素抵抗的关系。方法对26例肥胖患儿分为非NAFLD组(14例)、NAFLD组(12例)及20例正常儿童进行体格检查,采用标准方法检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TCH)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、空腹胰岛素(FINS),并计算稳态模型胰岛素抵抗指数(HOMA-IR)。结果 NAFLD组、非NAFLD组较对照组相比,体重、体质指数(BMI)、腰臀比(WHR)、FINS、IR、ALT、AST差异有统计学意义(P<0.05),3组相比,腰臀比(WHR)、FINS、IR、ALT、AST差异有统计学意义(P<0.05),而TCH、TG、LDL-C、HDL-C、FBG 3组之间差异无统计学意义(P>0.05)。NAFLD的发生与HOMA-IR、高胰岛素血症有明显的相关性,而HOMA-IR值与WHR、TG呈正相关(r=0.62,P<0.01,0.47,P<0.05)。结论肥胖儿童腰臀比对非酒精性脂肪肝(NAFLD)发病有一定的预测价值,胰岛素抵抗可能系儿童非酒精性脂肪肝发病的主要因素,肝功能损害是继发性因素。
Objective To study the relationship between non-alcoholic fatty liver disease and insulin resistance （IR） in obese adolescents. Methods Twenty-six obese children （ 12 cases of non-alcoholic fatty liver disease and 14 cases of obesity without fatty liver disease） and 20 normal individuals（ control group） were selected. The levels of alanine aminotransferase （ ALT ）, aspartate aminotransferase （ AST ）, total cholesterol （ TC ）, triglyceride （TG）, low density lipoprotein cholesterol（ LDL-C ）, high density lipoprotein cholesterol （ HDL-C ）, fasting blood-glucose （FBG） and fasting insulin （ FINS ） were tested using standard methods;the insulin resistance index was estimated by the homeostasis model assessment（ HO- MA-IR）. Results The body weight, body mass index （ BMI）, waist-to-hip ratio （ WHR）, FINS, HOMA-IR, ALT and AST were higher in NAFLD group and no-NAFLD group as compared with those in the control group;there were significant differences in WHR, FINS, HOMA-IR, ALT and AST among the three groups （ P 〈 0.05 ）, nut not in TCH, TG, LDL-C, HDL-C and FBG （ P 〉 0.05 ）. There were no significant differences in weight and BMI between NAFLD group and no NAFLD group. NAFLD in obese children was obviously related to IR and hyperinsulinemia, HOMA-IR was positively correlated to WHR and TG （ r = 0.62, P 〈 0.01,0.47, P 〈 0. 05 ）. Conclusion WHR has some predictive value for NAFLD. In the obese of non-alcoholic fatty liver disease,insulin resistance may be the original factor probably, and higher ALT and AST were the following changing.
出处
《中华全科医学》
2015年第10期1648-1649,1657,共3页
Chinese Journal of General Practice
关键词
儿童
非酒精性脂肪肝
肥胖
胰岛素抵抗
Adolescents
Non-alcoholic fatty liver disease
Obesity
Insulin resistance
