非酒精性脂肪肝患者血浆成纤维细胞生长因子21水平与肥胖、脂代谢及胰岛素抵抗的相关性

发布时间：2019-01-12 07:52

【摘要】：目的探讨非酒精性脂肪肝(NAFLD)患者血浆成纤维细胞生长因子(FGF)21水平与肥胖、脂代谢及胰岛素抵抗(IR)的相关性。方法选择2012年7月至2015年7月该院收治的NAFLD患者132例,根据患者是否合并2型糖尿病(T2DM)分为T2DM合并脂肪肝组(DFI组)与单纯脂肪肝组(FI组),另选择同期该院健康体检者60例为对照组,采用酶联免疫吸附法测定血浆FGF21水平,并检测其各项生理、生化指标,分析FGF21水平与肥胖、脂代谢及IR的相关性。结果 DFI组与FI组患者肥胖比例、体质量指数(BMI)、腰臀比(WHR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及游离脂肪酸(FFA)水平均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)水平显著低于对照组,DFI组患者BMI、WHR水平显著低于FI组,TG、空腹胰岛素(FINS)水平显著高于对照组(P0.05);DFI组与FI组患者空腹血糖(FPG)、IR指数(HOMA-IR)、FGF21水平均显著高于对照组,DFI组FPG、FNS、HAMO-IR水平显著高于FI组,FPG显著高于对照组,DFI组与FI组胰岛素敏感指数(ISI)水平均显对于对照组,DFI组ISI水平显著低于FI组(P0.05);研究对象血浆FGF21水平与BMI、HOMA-IR、WHR、FFA、TG呈正相关(r=0.261、0.322、0.341、0.310、0.301,P0.05),与ISI、HDL呈负相关(r=-0.215、-0.281,P0.05);多重线性回归分析显示,WHR、HOMA-IR及TG对机体血浆FGF21水平存在显著影响,且WHR对患者血浆FGF21水平的影响作用最大。结论 NAFLD患者血浆FGF21水平出现显著升高,机体FGF21水平与肥胖、脂代谢紊乱及IR相关,WHR、HOMA-IR及TG对机体血浆FGF21水平存在显著影响。
[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.
【作者单位】：河北大学附属医院消化内科;河北大学附属医院贵宾病房;河北省第七人民医院骨科;河北北方学院第一临床学院;
【分类号】：R575.5

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