【摘要】目的探讨不同糖代谢状态下发生非酒精性脂肪肝( NAFLD)的疾病谱、两者之间的关系及其影响因素。方法对我院2002年4月～2004年8月门诊肥胖人群中NAFDL 108例及对照人群49例测量身高、体重、腰围、臀围、血压；进行过夜空腹75g OGTT测定，同步测定FINS、2hINS、TC、TG、HDL-C、LDL-C、HbA1c、ALT、AST、γ-GT。结果(1)两组间糖耐量状态构成比的χ2检验(χ2=54.99>χ20.05(4)，P<0.05)；且较对照组：①发生空腹血糖受损(IFG)及T2DM的相对危险度增高(RRIFG=2.09，RRT2DM=7.43)。②胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI)(P<0.01)升高，FPG、2hPG、HbA1c、TC、TG、ALT、AST、γ-GT升高、HDL-C降低(均P<0.05)均具有统计学意义。(2)血糖(FPG、2hPG)与肝血清酶谱(①ALT、②AST、③γ-GT)的Pearson分析成正相关(FPG:r1=0.583 r2=0.276 r3=0.454，2hPG:r1=0.547 r2=0.257 r3=0.454，均P<0.01)。结论NAFLD可能与IFG同步发生或先于后者，随着病程延长可转变为糖尿病，建议NAFLD患者在糖耐量正常(NGT)阶段则可进行有关糖尿病教育，给予饮食、运动、药物干预治疗，定期随访血糖。

    关键词:不同糖耐量状态;非酒精性脂肪肝;空腹血糖受损;2型糖尿病

    Study on relationship between different glucose tolerance situations and nonalcoholic fatty liver disease

    Chen Yang

    Department of Endocrinology,The Central Hospital of Nanhui District,Shanghai 201300.

    【Abstract】ObjectiveTo investigate the relationship between different glucose tolerance situations and nonalcoholic fatty liver disease(NAFLD),the incidence profile of nonalcoholic fatty liver disease under different glucose tolerance situations and the related risk factors under nonalcoholic fatty liver disease formed.Methods108 cases with nonalcoholic fatty liver disease and 49 cases with the control population,which were outpatient with overweight and obesity in our hospital from Apr.2002 to Aug.2004,were examined in the height,weight,waist circumference,hip circumference,blood pressure.Then,they were tested in the oral 75g glucose tolerance test,meanwhile,were analyzed in the fasting plasma insulin(FINS),2 hours plasma insulin after glucose intake(2hINS),serum total cholesterol(TC),serum triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol (LDL-C),glycohemoglobinA1c (HbA1c),alanine aminotransferase (ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(γ-GT).Results(1)The constituent ratio for different glucose metabolic status between two groups were significantly different(χ2=54.99>χ20.05(4) ......