【摘要】 目的:分析深圳市机关职员1146人胰岛素抵抗(insulinresistance,IR)与血脂变化的关系。方法:脂肪肝组:诊断为非酒精性脂肪性肝病深圳某区机关职员201例,男161例,女40例。对照组体检正常的同期被调查者945例,男522例,女423例。调查内容有问卷,测量身高、体质量、体质量指数(bodymassindex,BMI),测定空腹总胆固醇、三酰甘油、低密度脂蛋白胆固醇(lowdensitylipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(highdensitylipoprotein-cholesterol,HDL-C)、空腹血糖、空腹胰岛素(fastingin-sulin,FINS)及肝脏B超等,稳态模型评价的胰岛素抵抗(homeostasismodelassessmentinsulinresistance,HOMA-IR)。结果:①校正年龄、性别、BMI后,脂肪肝组的BMI、腰围、腰臀比犤(26.2±2.4)kg/m2,(85.9±7.0)cm,0.88±0.05犦较对照组犤(22.5±2.7)kg/m2,(74.0±9.1)cm,0.81±0.08犦高(t=258.118,164.442,54.29,P<0.001),脂肪肝组HOMA-IR,FINS,三酰甘油,总胆固醇,LDL-C均高于对照组,而HDL-C低于对照组(t=12.200～258.118,P<0.001);②脂肪肝组HOMA-IR与三酰甘油正相关(r=0.370,P<0.001),与HDL-C负相关(r=-0.235,P=0.001),校正年龄、性别及BMI后也是如此(分别为r=0.373,-0.249,均为P<0.001)。③脂肪肝组多元逐步回归分析显示更多还原

【Abstract】 AIM:To analyze the relationship of insulin resistance(IR) with the changes of blood lipid in 1 146 officials of Shenzhen city. METHODS:Totally 201 officials of Shenzhen(161 males and 40 females),who were diagnosed to be with non alcoholic fatty liver disease,were resigned into the fatty liver group,and another 945 healthy controls(522 males and 423 females) were enrolled in the control group.The investigation included questionnaires,measurement of body mass,height and body mass index(BMI),and determination of fasting total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL C),high density lipoprotein cholesterol(HDL C),fasting plasma glucose and fasting insulin,B mode ultrasound of liver.Insulin resistance was determined by homeostasis model assessment insulin resistance(HOMA IR). RESULTS:①After adjustment of age,sex and BMI,the BMI,waistline and waist to hip ratio in the fatty liver group [(26.2±2.4)kg/m2,(85.9±7.0) cm and 0.88±0.05]were significantly higher than those in the control group[(22.5±2.7)kg/m2,(74.0±9.1) cm and 0.81±0.08](t=258.118,164.442,54.29,P< 0.001).The HOMA IR,fasting insulin,TG,TC and LDL C in the fatty group were all higher than those in the control group,while HDL C was lower than that in the control group(t=12.200-258.118,P< 0.001).②HOMA IR positively correlated with TG(r=0.370,P< 0.001) and negatively with HDL C(r=-0.235,P=0.001) in the fatty liver group, and so was after the adjustment of age,sex and BMI(r=0.373,-0.249,P< 0.001).③Multiple stepwise regression analysis suggested that HOMA IR was independently correlated with TG in the fatty liver group(t=5.699,P< 0.001). CONCLUSION:IR exists in patients with fatty liver,the changes of blood lipid are the increase of TG,TC and LDL C and the decrease of HDL C,and TG is independently correlated with IR.更多还原