CAJ | 학술논문

目的探讨代谢正常肥胖(MHO)合并非酒精性脂肪性肝病(NAFLD)患者的临床、生化特征及内皮功能.方法收集湖南省人民医院体检中心2006年4月-2014年1月体检人群的资料,排除资料不完整者,共5 147名.选择诊断为MHO患者(共478例)纳入研究,其中234例合并NAFLD(MHO合并NAFLD组),244例未合并NAFLD(MHO未合并NAFLD组).共获得56例MHO(29例为MHO合并NAFLD,27例为MHO未合并NAFLD)患者的血标本,检测C反应蛋白(CRP)、血清空腹胰岛素(FINS)、脂联素、内皮素-1,计算稳态模型评估-胰岛素抵抗指数(HOMA-IR),记录受检者身高、体重、收缩压、舒张压、甘油三酯、总胆固醇、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、空腹血糖、谷丙转氨酶(ALT)、尿酸、外周血白细胞计数(WBCC)及腹部B超结果.比较MHO合并NAFLD组与MHO未合并NAFLD组临床、生化特征、炎性因子及内皮素-1水平的差异.结果 MHO合并NFALD组与MHO未合并NAFLD组相比,年龄(t=-4.164)、体重指数(t=-4.519)、收缩压(t =-3.892)、空腹血糖水平(t=-2.549)、ALT(t =-2.019)、HOMA-IR(u=-2.091)、内皮素-1水平(u=-3.632)升高,脂联素水平(u=-2.206)降低(P均＜0.05).而性别、舒张压、甘油三酯、总胆固醇、LDL-C、HDL-C、尿酸、WBCC、FINS、CRP在两组间差别无统计学意义.结论 MHO合并NAFLD患者者代谢异常加重,内皮功能紊乱.
목적 탐토대사정상비반(MHO)합병비주정성지방성간병(NAFLD)환자적림상、생화특정급내피공능.방법 수집호남성인민의원체검중심2006년4월-2014년1월체검인군적자료,배제자료불완정자,공5 147명.선택진단위MHO환자(공478례)납입연구,기중234례합병NAFLD(MHO합병NAFLD조),244례미합병NAFLD(MHO미합병NAFLD조).공획득56례MHO(29례위MHO합병NAFLD,27례위MHO미합병NAFLD)환자적혈표본,검측C반응단백(CRP)、혈청공복이도소(FINS)、지련소、내피소-1,계산은태모형평고-이도소저항지수(HOMA-IR),기록수검자신고、체중、수축압、서장압、감유삼지、총담고순、저밀도지단백-담고순(LDL-C)、고밀도지단백-담고순(HDL-C)、공복혈당、곡병전안매(ALT)、뇨산、외주혈백세포계수(WBCC)급복부B초결과.비교MHO합병NAFLD조여MHO미합병NAFLD조림상、생화특정、염성인자급내피소-1수평적차이.결과 MHO합병NFALD조여MHO미합병NAFLD조상비,년령(t=-4.164)、체중지수(t=-4.519)、수축압(t =-3.892)、공복혈당수평(t=-2.549)、ALT(t =-2.019)、HOMA-IR(u=-2.091)、내피소-1수평(u=-3.632)승고,지련소수평(u=-2.206)강저(P균＜0.05).이성별、서장압、감유삼지、총담고순、LDL-C、HDL-C、뇨산、WBCC、FINS、CRP재량조간차별무통계학의의.결론 MHO합병NAFLD환자자대사이상가중,내피공능문란.
Objective To investigate the clinical parameters,biochemical parameters and endothelial function in metabolically healthy obese(MHO) patients with nonalcoholic fatty liver disease (NAFLD).Methods Data from 5 147 subjects undergone physical examination from April 2006 to January 2014 were collected in People's Hospital of Hunan Province.Among which 478 were diagnosed with MHO,and were included in this study.They were divided into two groups according to NAFLD status:MHO with NAFLD group (n =234),MHO without NAFLD group(n =244).In addition,blood samples from 56 subjects (29 MHO with NAFLD,27 MHO without NAFLD) were preserved to detect C-reactive protein(CRP),fasting insulin(FINS),adiponectin and endothelin-1 level.Homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated.Body height,body weight,systolic blood pressure,diastolic blood pressure,triglyceride,total cholesterol,low density lipoprotein cholesterol (LDL-C),high density lipopro-tein cholesterol (HDL-C),fast blood glucose,alanine aminotransferase (ALT),uric acid,peripheral white blood cell count(WBCC) and abdominal B ultrasound were recorded.Clinical parameters,metabolic parameters,the level of inflammatory cytokines and endothelin-1 were compared between MHO with NAFLD group and MHO without NAFLD group.Results Compared with MHO without NAFLD group,age(t =-4.164),body mass index(t=-4.519),systolic blood pressure (t =-3.892),fast blood glucose (t =-2.549),ALT (t =-2.019),HOMA-IR (u=-2.091),endothelin-1 (u=-3.632) were higher than those in MHO with NAFLD group,and adiponectin was lower than that in MHO with NAFLD group (u=-2.206,all P ＜0.05).There was no difference in sex,diastolic blood pressure,triglyceride,total cholesterol,LDL-C,H DL-C,uric acid,peripheral WBCC,FINS,CRP between the two groups.Conclusions Patients with MHO and NAFLD have aggravated metabolic abnormalities and endothelial dysfunction.