CAJ | 학술논문

目的探讨非酒精性脂肪性肝病患者肠道菌群变化及其与胰岛素抵抗的关系。方法选择非酒精性脂肪性肝病患者60例( NAFLD组)和健康体检者30例(对照组),对肠道中的4种细菌进行培养和计数,计算肠道定植抗力指标B/E值反映肠道菌群变化状态,比较两组间细菌数量及B/E值的变化；同时测定各临床指标,采用稳态模型胰岛素抵抗指数( HOMA-IR)评估胰岛素抵抗程度。结果①细菌数量及B/E值变化：与对照组相比,NAFLD组肠杆菌数量增加,双歧杆菌和乳杆菌数量减少(P<0.05),肠球菌两组间差异无显著性；B/E值明显降低(P<0.05)。②NAFLD组各临床指标及HOMA-IR明显增高(P<0.05)。③相关分析：B/E值与体重指数(BMI)等呈显著负相关(P<0.01)。④多元线性回归分析：在控制血压、血糖和血脂等因素后,B/E值是HOMA-IR的独立影响因素(R2=0.716,P<0.01)。结论非酒精性脂肪性肝病患者存在肠道菌群失调、肠道定植抗力受损,其程度与胰岛素抵抗程度密切相关,提示肠道菌群失调可能通过参与胰岛素抵抗而在非酒精性脂肪性肝病的发生、发展过程中发挥作用。
목적탐토비주정성지방성간병환자장도균군변화급기여이도소저항적관계。방법선택비주정성지방성간병환자60례( NAFLD조)화건강체검자30례(대조조),대장도중적4충세균진행배양화계수,계산장도정식항력지표B/E치반영장도균군변화상태,비교량조간세균수량급B/E치적변화；동시측정각림상지표,채용은태모형이도소저항지수( HOMA-IR)평고이도소저항정도。결과①세균수량급B/E치변화：여대조조상비,NAFLD조장간균수량증가,쌍기간균화유간균수량감소(P<0.05),장구균량조간차이무현저성；B/E치명현강저(P<0.05)。②NAFLD조각림상지표급HOMA-IR명현증고(P<0.05)。③상관분석：B/E치여체중지수(BMI)등정현저부상관(P<0.01)。④다원선성회귀분석：재공제혈압、혈당화혈지등인소후,B/E치시HOMA-IR적독립영향인소(R2=0.716,P<0.01)。결론비주정성지방성간병환자존재장도균군실조、장도정식항력수손,기정도여이도소저항정도밀절상관,제시장도균군실조가능통과삼여이도소저항이재비주정성지방성간병적발생、발전과정중발휘작용。
Objective To investigate changes of intestinal flora and correlation with insulin resistance ( IR) in nonal-coholic fatty liver disease patients. Method 60 patients with nonalcoholic fatty liver disease ( NAFLD group) and 30 normal subjects ( Control group) were selected and their intestinal bacteria were cultured and counted routinely. We counted intestinal colonization resistance index B/E value which can be used to reflecting changes of intestinal flora and compared changes of bacteria number and B/E value between the two groups. Clinical indexes were measured and insulin resistance was evaluated using steady-state model HOMA-IR. Result①Bacteria number and B/E val-ue:compared with control group, NAFLD group Enterobacteriaceae increased significantly, Bifid bacteria and Lac-tobacilli decreased significantly (P<0. 05), B/E value lower significantly (P<0. 05), and Enterococcus difference was not statistically significant. ②Clinical indexes and HOMA-IR of NAFLD group increased significantly ( P<0. 05).③Correlation analysis:the B/E value was negatively correlated with BMI,else (P<0. 01).④Multiple line-ar regression analysis:in the control of blood pressure, blood glucose and blood lipid and other factors, B/E value is independent risk factor of HOMA-IR (R2=0. 716, P<0. 01). Conclusion Patients with NAFLD existing intesti-nal flora imbalance and intestinal colonization resistance damaged, which is closely related with IR. Intestinal flora imbalance may be involved in IR and play a role in the occurrence and development of NAFLD.