非酒精性脂肪肝患者血浆FGF.docVIP

非酒精性脂肪肝血浆FGF21水平与肥胖、胰岛素抵抗关系1，刘汉屈1 （1重庆医科大学附属第一医院感染科重庆400016；2重庆医科大学附属第医院摘要 目的 探讨NAFLD）患者血浆成纤维细胞生长因子21（FGF21）水平及与肥胖、胰岛素抵抗等因素的相关性。方法NAFLD70例，根据是否合并糖尿病分为单纯脂肪肝组（FL组）和2型糖尿病合并脂肪肝组（DFL组），(NC组)26例采用酶联免疫分析法检测血浆FGF21水平，测定空腹血糖（FPG）、空腹胰岛素（FINS）、游离脂肪酸（FFA）、血脂水平，体指数（BMI）腰臀比（WHR）；采用稳态模型HOMA-IR和胰岛素敏感指数(ISI)评价胰岛素抵抗状态。结果 （1）两组脂肪肝患者中，肥胖比例、BMI及WHR均显著高于NC组，甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、FFA显著增高，高密度脂蛋白胆固醇（HDL-C）降低；T2DM合并脂肪肝组HOMA-IR明显增高，ISI显著降低；（2）单纯脂肪肝和T2DM合并脂肪肝患者血浆FGF21水平明显高于健康对照组[分别为（1.86±0.64）和(1.97±0.60）ng /ml vs ( 1.26±0.43) ng/ml]，均P﹤0.05];（3）相关分析显示，血浆FGF21水平与BMI、WHR 、HOMA-IR、TG、FFA呈正相关，与HDL、ISI呈负相关; 多元逐步回归分析显示WHR、HOMA-IR、TG是血浆FGF21的独立相关因素。结论 NAFLD 患者血浆FGF21水平升高，FGF21与肥胖、胰岛素抵抗、脂代谢紊乱，推测FGF21可能在脂肪肝的发生、发展中起了一定的作用。 关键词 非酒精性脂肪肝FGF21；胰岛素抵抗肥胖 Preliminary probe into the relationship of plasma FGF21 levels, obesity and insulin resistance in Nonalcoholic fatty liver patients ZHOU Ting-ting1, QIN Bo1 ，ZHENG Tianpeng2 ，ZHU Qirong1， LIU Hanqu1 （1Department of Infectious disease, The First Affiliated Hospital of Chongqing University of Medical Science, Chongqing 400016 .2 Department of Endocrinology, The Second Affiliated Hospital of Chongqing University of Medical Science, Chongqing 400010 ,China.） ） Abstract: Objective：o investigate the relationship between plasma FGF21 level, obesity and insulin resistance (IR) in nonalcoholic fatty liver patients. Method： without type 2 diabetics, the 70 cases of NAFLD patients were divided into fatty liver (FL，36 cases) -------------------------------- 作者：周婷婷女硕士研究生Email：467423730@ 通讯作者：秦波Email：cqqinbo@126.comtype 2 diabetes complicated with fatty liver (DFL，34 cases)group；There are 26 subjects in the normal control (NC) group. The plasma FGF21 level of the subjects in those groups were determined by enzyme-linked immunosorbent assay method; At the same time, fasting plasma glucose (FPG), fasting insulin(FINS), free fatty acid(FFA), lipid levels were also tested, and measurement of height, weight and WHR were implemented; The state of insulin res