[1]周婷婷,秦波,郑天鹏,等.非酒精性脂肪肝患者血浆FGF21水平及与肥胖、胰岛素抵抗关系研究[J].陆军军医大学学报(原第三军医大学学报),2010,32(03):265-268.
 Zhou Tingting,Qin Bo,Zheng Tianpeng,et al.Correlation between plasma fibroblast growth factor 21 level, obesity and insulin resistance in nonalcoholic fatty liver disease patients[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(03):265-268.
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非酒精性脂肪肝患者血浆FGF21水平及与肥胖、胰岛素抵抗关系研究(/HTML )
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陆军军医大学学报(原第三军医大学学报)[ISSN:1000-5404/CN:51-1095/R]

卷:
32卷
期数:
2010年第03期
页码:
265-268
栏目:
论著
出版日期:
2010-02-15

文章信息/Info

Title:
Correlation between plasma fibroblast growth factor 21 level, obesity and insulin resistance in nonalcoholic fatty liver disease patients
作者:
周婷婷秦波郑天鹏朱其荣刘汉屈
重庆医科大学附属第一医院感染科;重庆医科大学附属第二医院内分泌科
Author(s):
Zhou Tingting Qin BoZheng TianpengZhu Qirong Liu Hanqu
Department of Infectious Diseases, First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016; Department of Endocrinology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China
关键词:
非酒精性脂肪肝成纤维细胞生长因子21胰岛素抵抗肥胖
Keywords:
nonalcoholic fatty liverfibroblast growth factor 21insulin resistanceobesity
分类号:
R575.502;R341;R589.2
文献标志码:
A
摘要:
目的  探讨非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)患者血浆成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)水平及与肥胖、胰岛素抵抗等因素的相关性。  方法  根据是否合并糖尿病将70例NAFLD患者分为单纯脂肪肝组36例和2型糖尿病合并脂肪肝组34例,正常对照组26例,采用酶联免疫分析法检测血浆FGF21水平,并测定空腹血糖(fasting plasma glucose, FPG)、空腹胰岛素(fasting insulin, FINS)、游离脂肪酸(free fatty acids,  FFA)、血脂水平,以及体质量指数(body mass index, BMI)、腰臀比(waist-to-hipratio, WHR);采用稳态模型HOMA-IR和胰岛素敏感指数(insulin sensitivity index,ISI)评价胰岛素抵抗状态。  结果  ①2组脂肪肝患者中,肥胖比例、BMI及WHR均显著高于正常对照组,甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low  density lipoprotein cholesterol,LDL-C)、FFA显著增高(P<0.05,P<0.01),高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)降低(P<0.05);糖尿病合并脂肪肝组HOMA-IR明显增高(P<0.01),ISI显著降低(P<0.05)。②单纯脂肪肝和糖尿病合并脂肪肝患者血浆FGF21水平[(1.86±0.64)、(1.97±0.60)ng/ml]明显高于健康对照组[(1.26±0.43) ng/ml,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(r=0.278、0.335、0.326、0.312、0.307,P<0.05,P<0.01),与HDL、ISI呈负相关(r=-0.255、-0.279,P<0.05)。④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、脂代谢紊乱有关,FGF21可能在脂肪肝的发生、发展中起了一定的作用。
Abstract:
Objective  To investigate the correlation between plasma fibroblast growth factor 21 (FGF21) level, obesity and insulin resistance (IR) in nonalcoholic fatty liver disease (NAFLD) patients.   Methods  Seventy NAFLD patients were divided into fatty liver (FL) group (n=36), type 2 diabetes complicated by fatty liver (DFL) group (n=34 cases), and normal control (NC) group (n=26) according to their complication of type 2 diabetics. Levels of plasma FGF21, fasting plasma glucose (FPG), fasting insulin (FINS), free fatty acid (FFA), lipid, body mass index (BMI) and waist-to-hip ratio (WHR) were measured by enzyme-linked immunosorbent assay. Insulin resistance was evaluated using the steady-state model HOMA-IR and insulin sensitivity index (ISI).   Results  The levels of obesity, BMI, WHR, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and FFA were significantly higher in FL and type 2 DFL groups than in NC group(P<0.05, P<0.01). The high-density lipoprotein cholesterol (HDL-C) level was lower in FL and type 2 DFL groups than in NC group(P<0.05). The HAMO-IR was significantly higher and ISI was notably lower in type 2 DFL group than in NC group(P<0.01, 0.05). The plasma FGF21 level was significantly higher in FL and type 2 DFL groups (1.86±0.64) ng/ml and (1.97±0.60) ng/ml than in NC group (1.26±0.43) ng/ml (P<0.05). Correlation analysis showed that the plasma FGF21 level was positively correlated with BMI, WHR, HOMA-IR, TG, and FFA(r=0.278, 0.335, 0.326, 0.312, and 0.307), respectively (P<0.05 or P<0.01), and negatively correlated with HDL and ISI(r=-0.255,-0.279), respectively (P<0.05). Multiple stepwise regression analysis indicated that WHR, HOMAIR and TG were the independently relevant factors for serum FGF21 level.   Conclusion  Elevated plasma FGF21 level in NAFLD patients is closely related with obesity, insulin resistance and lipid metabolism disorder, and may play a role in the occurrence and development of FL.

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更新日期/Last Update: 2010-01-27