【摘要】 目的探讨代谢综合征(MS)患者超声测量的双肾下极脂肪囊面积(US-AIPPF)与中重度非酒精性脂肪肝(NAFLD)的关系。方法72例MS患者,测量其腰围、臀围、身高、体重、血压、空腹血糖、胰岛素、血脂、尿酸和C反应蛋白,超声诊断NAFLD并分期,测量US-AIPPF。结果MS患者中合并中重度NAFLD者的US-AIPPF、腰围、腰臀比(WHR)、体块指数(BMI)比轻度或无脂肪肝组更大(均<0.01),也伴随了更高的血压、胰岛素抵抗、尿酸、C反应蛋白、丙氨酸转氨酶及更紊乱的脂代谢(除HDL-C外,均<0.05)。US-AIPPF预测MS患者合并中重度NAFLD优于其他参数(ROC曲线下面积=0.941)。US-AIPPF是预测MS患者合并中重度NAFLD的独立危险因子。结论US-AIPPF可以作为一个简单、可靠的超声指标来预测MS患者是否合并中重度NAFLD。更多还原

【Abstract】 Objective To investigate the relationship between ultrasound measured area of the inferior pole of the perirenal fat(US-AIPPF) and moderate to severe non-alcoholic fatty liver disease(NAFLD) in the metabolic syndrome(MS).Methods Seventy two subjects with MS were recruited including 44 men and 28 women(age:26-68 years).Each subject underwent ultrasound detection of US-AIPPF, fatty liver diagnosis and staging.Anthropometric and metabolic parameters were also evaluated.Results MS combined with moderate to severe NAFLD not only demonstrated greater US-AIPPF, waist circumference, body mass index and the ratio of waist and hip circumference(sP< 0.01), but also accompanied with higher blood pressure, insulin resistance, uric acid, C-reactive protein, alanine transaminase level and more disordered lipid metabolism(P< 0.05).Receiver operating characteristic(ROC) analysis revealed that the ability of US-AIPPF and MRI-VAT to predict MS combined with moderate to severe NAFLD was superior to and independent of other parameters.Binary logistic regression analysis confirmed that MRI VAT, US-AIPPF was the independent variable among the investigated obesity indexes and other parameters related to the occurrence of moderate to severe NAFLD in the metabolic syndrome(P<0.001).Conclusion This study shows that US-AIPPF can be applied as an easy and reliable imaging indicator of moderate to severe NAFLD in the MS.更多还原