血清脂联素与老年人非酒精性脂肪肝的相关性研究.pdfVIP

化及介 诊疗2007年第12卷第4期Modem DigestionIntervention 2007，Vo1．12，No．4 —213一 · 论 著· 血清脂联素与老年人非酒精性脂肪肝的相 关性研究 王中丽 夏 冰 王 桦· 胡正国 陈青松。 程金童。 文 斌。 【摘要】目的探讨血清脂联素水平、胰岛素抵抗与老年人NAFLD及其合并代谢紊乱的相关性。方 法 随机选取NAFLD合并代谢紊乱患者89例，NAFLD患者95例，正常对照8O例，测定BMI及临床生 化指标并进行肝脏B超检查。放射免疫法测定空腹胰岛素水平，计算HOMA指数 同时ELISA法测定血 清脂联素水平。将老年组与青年组、老年肥胖组与非肥胖组进行比较。结果 老年人NAFLD存在胰岛素 抵抗及血脂、血糖及肝功能代谢异常，脂联素水平降低，合并代谢紊乱者脂联素水平更低 老年人NAFLD 合并代谢紊乱者血清脂联素水平高于年轻患者。老年肥胖及年轻NAFLD容易发生肝功能异常。多元回 归分析表明，脂联素与BMI、性别及HOMA相关。结论 老年人NAFLD及其合并代谢紊乱患者胰岛素抵 抗严重，脂联素水平降低；老年肥胖NAFLD患者更容易发生ALT异常。血清脂联素水平与BMI、性别及 HOMA相关，与年龄无显著相关性。 【关键词】老年人；非酒精性脂肪肝；代谢紊乱；脂联素 The association between adiponectine and non-alcoholic fatty liver disease in elderly people WANG Zhong一 XIA Bing，WANG Hua，et a1．Department ofInternal Medicine＆Geriatrics,Wuhan University Zhongnan Hospital,Wuhan 480071，China ． 【Abstract】0bjective To investigate the serum adiponectin concentration and insulin resistance in rela卜 ed to NAFLD and its metabolic disorders in elderly people． Methors A total Of 89 NAFLD patients witl1 metabolic disorders(hypertension or fasting hyperglycemia)，95 patients with NAFLD，and 80 healthy controls were studied．Abdominal ultrasound was taken for fatty liver examination．Anthropometric and biochemical variables were measured by routine methods． Serum adiponectin and insulin levels were determined by en- zyme-linked immunosorbent assay and radioimmunoassay． Insulin resistance indexes were assessed by HOMA—IR．Results The BMI，TC，TG，FBS，ALT level，fasting insulin and HOMA were significantly in- creased in aged NAFLD patients，while serum adiponectin concentration was significantly decreased，and even more serious in those with metabolic disorders． The extent of insulin resistance of aged NAFLD individuals was obvious． Obesity in elderly peo