CAJ | 학술논문

目的：分析单纯性肥胖患者血清铁蛋白（SF）水平与脂肪肝发生率、胰岛素抵抗（IR）的关联性。方法入选单纯性肥胖患者78例，其中Ⅰ度肥胖34例，Ⅱ度肥胖30例，Ⅲ度肥胖14例。另选单纯性超重成年人35例，健康成年人67例做为对照组。所有受试者均测定身高、体质量、臀围、腰围、SF、血脂、空腹胰岛素（FIN）、空腹血糖（FBG）水平，B 超确诊脂肪肝，计算脂肪肝发生率、胰岛素抵抗指数（HOMA-IR）、体质量指数（BMI）及腰臀比（WHR）。结果随着 BMI 的升高，受试者 SF、FBG、FIN、HOMA-IR、TG、TC、LDL-C 水平亦逐渐上升（F ＝378．92、112．01、55．50、123．96、90．09、127．65、23．81，均 P ＜0．01）、HDL-C 水平则逐渐下降（F ＝114．56，P ＜0．01）；脂肪肝发生率Ⅰ度肥胖组＜Ⅱ度肥胖组＜Ⅲ度肥胖组，差异均有统计学意义（t ＝24.872、7.885，均 P ＜0．01），SF 水平和四分位间距脂肪肝组显著大于非脂肪肝组，差异有统计学意义（t ＝22.99，P ＜0．01）；SF 与 BMI、WRH、FBG、FIN、HOMA-IR、TC、TG、LDL-C 水平呈显著正相关（r ＝0．863、0．719、0．789、0.703、0．617、0．785、0．717、0．771，均 P ＜0．01），与 HDL-C 呈负相关（r ＝－0．530，P ＜0．01）；多因素逐步回归分析提示，影响 HOMA-IR 的独立危险因素是 SF、BMI、FBG、FIN、LDL-C（t ＝6．535、3．254、18．827、61.227、2.154，均 P ＜0．05），影响 SF 的独立危险因素是 BMI、FIN、LDL-C、HOMA-IR（t ＝4．646、2．595、－5．073、6.666，均 P ＜0．01）。结论单纯性肥胖患者存在明显的血脂代谢异常及 IR、易并发脂肪肝，脂肪肝发生率与肥胖严重程度相关，SF 过量表达与其具有密切关联。
목적：분석단순성비반환자혈청철단백（SF）수평여지방간발생솔、이도소저항（IR）적관련성。방법입선단순성비반환자78례，기중Ⅰ도비반34례，Ⅱ도비반30례，Ⅲ도비반14례。령선단순성초중성년인35례，건강성년인67례주위대조조。소유수시자균측정신고、체질량、둔위、요위、SF、혈지、공복이도소（FIN）、공복혈당（FBG）수평，B 초학진지방간，계산지방간발생솔、이도소저항지수（HOMA-IR）、체질량지수（BMI）급요둔비（WHR）。결과수착 BMI 적승고，수시자 SF、FBG、FIN、HOMA-IR、TG、TC、LDL-C 수평역축점상승（F ＝378．92、112．01、55．50、123．96、90．09、127．65、23．81，균 P ＜0．01）、HDL-C 수평칙축점하강（F ＝114．56，P ＜0．01）；지방간발생솔Ⅰ도비반조＜Ⅱ도비반조＜Ⅲ도비반조，차이균유통계학의의（t ＝24.872、7.885，균 P ＜0．01），SF 수평화사분위간거지방간조현저대우비지방간조，차이유통계학의의（t ＝22.99，P ＜0．01）；SF 여 BMI、WRH、FBG、FIN、HOMA-IR、TC、TG、LDL-C 수평정현저정상관（r ＝0．863、0．719、0．789、0.703、0．617、0．785、0．717、0．771，균 P ＜0．01），여 HDL-C 정부상관（r ＝－0．530，P ＜0．01）；다인소축보회귀분석제시，영향 HOMA-IR 적독립위험인소시 SF、BMI、FBG、FIN、LDL-C（t ＝6．535、3．254、18．827、61.227、2.154，균 P ＜0．05），영향 SF 적독립위험인소시 BMI、FIN、LDL-C、HOMA-IR（t ＝4．646、2．595、－5．073、6.666，균 P ＜0．01）。결론단순성비반환자존재명현적혈지대사이상급 IR、역병발지방간，지방간발생솔여비반엄중정도상관，SF 과량표체여기구유밀절관련。
Objective To explore the relationship of serum ferritin with insluin resistance(IR)and inci-dence of fatty liver in adults with simple obesity.Methods According to body mass index (BMI),78 adults with simple obesity were divided into three groups,including 34 cases in Ⅰ degree obesity group,30 cases in Ⅱ degree obesity group and 14 cases in Ⅲ degree obesity group,and 35 adults with simple overweight and 67 healthy adults were also enrolled as control group.The height,weight,waistline,hip circumference,incidence of fatty liver,fasting blood glucose (FBG),fasting insulin (FIN),blood lipids and ferritin(SF)level were tested,and the body mass index (BMI),WHR and IR index (HOMA -IR)were calculated.Results When BMI increased,levels of SF,HOMA -IR, FBG,FIN,triglyceride (TG),cholesterol (TC),low density lipoprotein -cholesterol (LDL -C)were gradually increased(F =378.92,12.01,55.50,123.96,90.09,127.65,23.81,all P <0.01).However,high density lipopro-tein -cholesterol (HDL -C)was gradually degraded(F =114.56,P <0.01).The incidence of fatty liver had signifi-cant differences in Ⅰ,Ⅱ,Ⅲ degree obesity groups((t =24.872,7.885,all P <0.01),and with the degree of obesity increased,the rate of fatty liver increased significantly.SF range interquartile and level in fatty liver group was signifi-cantly greater than the non fatty liver group,the difference was statistically significant (t =22.99,P <0.01).SF was positively correlated with BMI,WRH,FBG,FIN,HOMA -IR,TC,TG,LDL -C (r =0.863,0.719,0.789,0.703, 0.617,0.785,0.717,0.771,all P <0.01),and negatively correlated with HDL -C(r =-0.530,P <0.01).Multi-ple stepwise regression analysis indicated that BMI,FIN,LDL -C,HOMA -IR were independent risk factors affecting SF(t =4.646,2.595,-5.073,6.666,all P <0.01).SF,BMI,FBG,FIN,LDL -C were independent risk factors influencing HOMA -IR(t =6.535,3.254,18.827,61.227,2.154,all P <0.05).Conclusion Simple obesity adults had obvious blood lipid disorders and IR,easy to complicated with fatty liver,the incidence of fatty liver associ-ated with severity of obesity,the overexpression of SF is closely related to it.