摘要
目的探讨非肥胖的高血压病患者的非酒精性脂肪肝(NAFLD)与胰岛素抵抗(IR)的相关性。方法93例非肥胖的不伴有糖尿病的高血压病患者,根据B超诊断有无脂肪肝分为高血压伴NAFLD45例,高血压不伴NAFLD48例。对两组患者的体重指数(BMI)、血压、血糖、血脂、血胰岛素、胰岛素抵抗指数(HOMAIR)及转氨酶等指标进行比较分析,并对NAFLD与上述指标的关系进行多因素的logistic回归分析。结果高血压伴NAFLD组的BMI(25.2±1.5vs24.1±1.9,P=0.002)、甘油三酯(2.3±1.0vs1.9±0.8,P=0.034)、空腹胰岛素(15.0±6.0vs10.9±5.3,P=0.001)、口服75g葡萄糖后2h胰岛素(50.5±22.4vs37.9±16.0,P=0.003)、丙氨酸氨基转移酶(ALT)(22.8±8.9vs16.7±6.7,P<0.001)、天门冬氨酸氨基转移酶(18.8±6.4vs16.2±5.1,P=0.030)及HOMAIR(1.2±0.5vs0.8±0.5,P=0.001)较不伴NAFLD组显著增高,而且NAFLD与HOMAIR(OR2.847,95%CI1.122～7.228;P=0.028)及ALT(OR1.075,95%CI1.013～1.140;P=0.016)呈独立相关。结论高血压病伴NAFLD患者有更显著的IR,而且在非肥胖的高血压病患者中,IR是NAFLD的独立危险因素。
Objective To investigate the relationship between insulin resistance and nonalcoholic fatty liver disease （NAFLD） in non-obese hypertensive patients. Methods Ninety-three non-obese, non-diabetic hypertensive patients were grouped as hypertensive patients with NAFLD（n = 45 ） and hypertensive patients without NAFLD（n=48） diagnosed uhrasonography. Body mass index（BMI）, blood pressure, fast and OGGT 2 hour plasma glucose, fast and OGGT 2 hour plasma insulin, plasma lipids and aminotransferase were measured. Insulin resistance（IR） was estimated from plasma insulin and glucose as the homeostasis model assessment（ HOMA） index. Multivariate logistic regression analysis was used to identify the variables associated with NAFLD. Result The group with NAFLD had significantly higher BMI （25.2±1.5 vs 24.1±1.9, P=0.002）, triglycerides（2.3±1.0 vs 1.9±0.8, P=0.034）, fast insulin （15.0±6.0 vs 10. 9±5.3, P=0. 001）, OGGT 2 hour insulin（50.5±22.4 vs 37.9±16.0, P=0. 003） alanine anainotrans[erase（ALT） （ 22.8 ± 8.9 vs 16.7 ± 6.7, P〈0. 001 ）, aspartate aminotransferase （AST） （18.8±6.4 vs 16.2±5.1, P=0. 030）and HOMA-IR（1.2±0. 5 vs 0. 8±0. 5, P〈0. 001）than the group without NAFLD. Multivariate logistic regression analysis （ forward LR） showed HOMA-IR（ OR 2. 847, 95% CI 1. 122-7.228; P=0. 028 ） and ALT（OR 1.075, 95% CI 1.013-1. 140;P=0.016）were independently associated with NAFLD. Conclusion Hypertensive patients with NAFLD have significantly higher insulin resistance than those without NAFLD. Insulin resistance is an independent risk factor for NAFLD in non-obese hypertensive patients.
出处
《高血压杂志》
CSCD
北大核心
2006年第3期193-195,共3页
Chinese Journal of Hypertension
关键词
脂肪肝
高血压
胰岛素抵抗
危险因素
Fatty liver
Hypertension
Insulin resistance
Risk factors
