中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2009年
2期
120-123
,共4页
陶婷%吴霖%沈倍倍%赵咏桔
陶婷%吳霖%瀋倍倍%趙詠桔
도정%오림%침배배%조영길
脂肪肝,非酒精性%脂联素%瘦素%面积,腹部脂肪%老年男性
脂肪肝,非酒精性%脂聯素%瘦素%麵積,腹部脂肪%老年男性
지방간,비주정성%지련소%수소%면적,복부지방%노년남성
Fatty liver,nonalcoholic%Adiponectin%Leptin%Abdominal adipose area%Elderlymen
目的 研究老年男性非酒精性脂肪肝(NAFLD)患者腹部脂肪面积及血清脂联素和瘦素水平的变化.方法 选择238名年龄≥60岁的老年男性,应用B超诊断脂肪肝,依据病史排除酒精性及病毒性脂肪肝.分为3组:脂肪肝组76例,年龄、体重指数与脂肪肝组匹配的非脂肪肝组77名(肥胖组),非肥胖非脂肪肝组85名(对照组).采用放射免疫法测定血清脂联素、瘦素水平;采用CT扫描测定腹部内脏脂肪面积.组间比较采用方差分析.结果 (1)脂肪肝组与肥胖组的体重指数、腹部皮下、内脏、总脂肪面积分别为(26.87±2.62)kg/m2与(26.63±1.97)kg/m2、(166.59±54.27)cm2与(147.89±50.14)cm2、(148.94±53.72)cm2与(150.06±45.47)cm2、(315.25±89.42)cm2与(297.93±75.12)cm2,均高于对照组(P＜0.01).脂肪肝组的腹部皮下脂肪面积高于肥胖组(P＜0.05),而两者的腹部内脏及总脂肪面积差异无统计学意义.(2)脂肪肝组与肥胖组间的瘦素水平差异无统计学意义,但均高于对照组.NAFLD组的脂联素水平明显低于肥胖组[(6.31±3.31)μg/ml对比(9.87±7.07)μg/ml,P＜0.01],也明显低于对照组[(6.31±3.31)μg/ml对比(11.05±7.19)μg/ml,P＜0.01];肥胖组与对照组间脂联素水平差异无统计学意义.(3)非酒精性脂肪肝的高危因素包括天冬氨酸转氨酶、甘油三酯、腹部内脏及皮下脂肪面积.血脂联素水平是非酒精性脂肪肝的保护性因素.结论 老年男性非酒精性脂肪肝患者的特征是腹型肥胖,瘦素水平高,脂联素水平低.其中脂联素水平的下降在其中起关键作用.
目的 研究老年男性非酒精性脂肪肝(NAFLD)患者腹部脂肪麵積及血清脂聯素和瘦素水平的變化.方法 選擇238名年齡≥60歲的老年男性,應用B超診斷脂肪肝,依據病史排除酒精性及病毒性脂肪肝.分為3組:脂肪肝組76例,年齡、體重指數與脂肪肝組匹配的非脂肪肝組77名(肥胖組),非肥胖非脂肪肝組85名(對照組).採用放射免疫法測定血清脂聯素、瘦素水平;採用CT掃描測定腹部內髒脂肪麵積.組間比較採用方差分析.結果 (1)脂肪肝組與肥胖組的體重指數、腹部皮下、內髒、總脂肪麵積分彆為(26.87±2.62)kg/m2與(26.63±1.97)kg/m2、(166.59±54.27)cm2與(147.89±50.14)cm2、(148.94±53.72)cm2與(150.06±45.47)cm2、(315.25±89.42)cm2與(297.93±75.12)cm2,均高于對照組(P＜0.01).脂肪肝組的腹部皮下脂肪麵積高于肥胖組(P＜0.05),而兩者的腹部內髒及總脂肪麵積差異無統計學意義.(2)脂肪肝組與肥胖組間的瘦素水平差異無統計學意義,但均高于對照組.NAFLD組的脂聯素水平明顯低于肥胖組[(6.31±3.31)μg/ml對比(9.87±7.07)μg/ml,P＜0.01],也明顯低于對照組[(6.31±3.31)μg/ml對比(11.05±7.19)μg/ml,P＜0.01];肥胖組與對照組間脂聯素水平差異無統計學意義.(3)非酒精性脂肪肝的高危因素包括天鼕氨痠轉氨酶、甘油三酯、腹部內髒及皮下脂肪麵積.血脂聯素水平是非酒精性脂肪肝的保護性因素.結論 老年男性非酒精性脂肪肝患者的特徵是腹型肥胖,瘦素水平高,脂聯素水平低.其中脂聯素水平的下降在其中起關鍵作用.
목적 연구노년남성비주정성지방간(NAFLD)환자복부지방면적급혈청지련소화수소수평적변화.방법 선택238명년령≥60세적노년남성,응용B초진단지방간,의거병사배제주정성급병독성지방간.분위3조:지방간조76례,년령、체중지수여지방간조필배적비지방간조77명(비반조),비비반비지방간조85명(대조조).채용방사면역법측정혈청지련소、수소수평;채용CT소묘측정복부내장지방면적.조간비교채용방차분석.결과 (1)지방간조여비반조적체중지수、복부피하、내장、총지방면적분별위(26.87±2.62)kg/m2여(26.63±1.97)kg/m2、(166.59±54.27)cm2여(147.89±50.14)cm2、(148.94±53.72)cm2여(150.06±45.47)cm2、(315.25±89.42)cm2여(297.93±75.12)cm2,균고우대조조(P＜0.01).지방간조적복부피하지방면적고우비반조(P＜0.05),이량자적복부내장급총지방면적차이무통계학의의.(2)지방간조여비반조간적수소수평차이무통계학의의,단균고우대조조.NAFLD조적지련소수평명현저우비반조[(6.31±3.31)μg/ml대비(9.87±7.07)μg/ml,P＜0.01],야명현저우대조조[(6.31±3.31)μg/ml대비(11.05±7.19)μg/ml,P＜0.01];비반조여대조조간지련소수평차이무통계학의의.(3)비주정성지방간적고위인소포괄천동안산전안매、감유삼지、복부내장급피하지방면적.혈지련소수평시비주정성지방간적보호성인소.결론 노년남성비주정성지방간환자적특정시복형비반,수소수평고,지련소수평저.기중지련소수평적하강재기중기관건작용.
Objective To study the abdominal adipose area,serum adiponectin and leptin levels of nonalcoholic fatty liver disease in elderly males.Methods A total of 238 elderly males(≥60 years)were enrolled and divided into three groups:Nonalcoholic fatty liver disease(NAFLD)group(n=76),matching group(age and body mass index matching with NAFLD group,n=77),normal control group(n=85).Serum levels of adiponectin and leptin were measured by RIA(radiological immunological assay).Abdominal adipose area was detected by computer tomography.Result(1)body mass index(BMI),abdominal subcutaneOUS adipose area,visceral adipose area,total adipose area of NAFLD group and matching group were(26.87±2.62)kg/m2 and(26.63±1.97)kg/m2,(166.59±54.27)cm2 and(147.89±50.14)cm2,(148.94±53.72)cm2 and(150.06±45.47)cm2,(315.25±89.42)cm2 and(297.93±75.12)cm2,respectively;and were higher than those in control group(P＜0.01).The abdominal subcutaneous adipose area is higher in NAFLD group than in matching group,however,the abdominal visceral adipose area and total adipose area were not significantly different between those two groups.(2)The serum leptin level in NAFLD group and matching group was significantly higher than that in control group,and serum leptin level was not significantly different between NAFLD group and matching group.The serum adiponectin of NAFLD group [(6.31 ±3.31) μg/ml] was significantly lower than that of matching group [(9.87 ±7.071)μg/ml,P ＜ 0.01] and control group (P＜0.01).There was no difference in adiponectin level between matching group and control group.3) AST,TG,abdominal subcutaneous adipose area,abdominal visceral adipose area were risk factors of NAFLD,while serum adiponectin was protective factor of NAFLD.Conclusion These data indicate that elderly male NAFLD patients manifest abdominal obesity,high serum leptin,low serum adiponecin,and suggest that adiponectin may play a crucial role in the pathogenesis of NAFLD in elderly males.
