2型糖尿病伴非酒精性脂肪肝患者胰岛素抵抗及游离脂肪酸关系探究.doc

2型糖尿病伴非酒精性脂肪肝患者胰岛素抵抗及游离脂肪酸关系探究[摘要] 目的：了解2型糖尿病伴非酒精性脂肪肝（NAFLD）患者胰岛素抵抗（IR）与游离脂肪酸（FFA）的关系。方法：2型糖尿病伴非酒精性脂肪肝患者39例、单纯2型糖尿病患者42例、单纯非酒精性脂肪肝患者40例、健康人群42例为研究对象。检测所有对象的FFA、胰岛素敏感性指数（ISI）以及总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）等指标。结果：2型糖尿病伴非酒精性脂肪肝组的FFA、ISI、TC、TG和LDL-C分别为（697.58±45.12） μmol/L，－4.99±0.12，（6.72±1.26）、（3.14±0.98）、（3.56±0.99） mmol/L； FFA、TC、TG、LDL-C等各项指标均以2型糖尿病伴非酒精性脂肪肝组高于其余各组（均P＜0.05）；ISI则以2型糖尿病伴非酒精性脂肪肝组低于其余各组（均P＜0.05）；将2型糖尿病伴非酒精性脂肪肝组的FFA与ISI、血脂3项指标作相关性分析。结果显示，FFA与ISI呈负相关（r＝－0.773，P＜0.05），与TC、TG、LDL-C呈正相关（分别为r＝0.791，0.816，0.873，均P＜0.05）。结论：在2型糖尿病伴非酒精性脂肪肝中，FFA升高与IR是并存的，并且存在明显相关关系，二者在疾病的发生发展中均具有重要的作用。 [关键词] 2型糖尿病；非酒精性脂肪肝；胰岛素抵抗；游离脂肪酸 [中图分类号] R587 [文献标识码]A [文章编号]1673-7210（2008）06（a）-050-03 Relationship between insulin resistance and free fatty acids in patients of type two diabetes mellitus with non-alcoholic fatty liver disease（NAFLD） TIAN Feng1,YANG Shuo2,ZHENG Zhi-gang1,ZHOU Xiao-guang3 (1.Department of Internal Medcine,Yan-gang Hospital of Yantian District,Shenzhen City,Shenzhen518083,China;2.Department of Internal Medcine,Anbu Huaqiao Hospital of Chaozhou City,Chaozhou515638,China;3.Depatment of Emergency,Guangming Hospital of Shenzhen City,Shenzhen 518107,China) [Abstract] Objective: To explore the relaionship between insulin resistance(IR) and free fatty acids(FFA) in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease(NAFLD).Methods:The patients of type 2 diabetes mellitus with NAFLD (39 cases),type 2 diabetes alone(42 cases), NAFLD alone(40 cases) were selected as case groups,while the healthy individuals(42 cases) were selected as control group.FFA,insulin-sensitivity index(ISI),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-C) were tested for each subject.Results:The levels of FFA,ISI,TC,TG and LDL-C of type two diabetes mellitus CHD were(697.58±45.12) μmol/L,-4.99±0.12,(6.72±1.26) mmol/L,(3.14±0.98) mmol/L,(3.56±0.99) mmol/L,respectively.The levels of FFA,TC,TG,LDL-C of the type two diabetes mellitus compan