作者单位：528200 佛山，南方医科大学附属南海医院内分泌科

    胰岛素抵抗与HBV携带者合并非酒精性脂肪肝的关系

    曾春平陈幼萍刘帅舒毅梁蕴谊

    【摘要】目的探讨胰岛素抵抗(IR)与HBV携带者发生非酒精性脂肪肝(NAFLD)的相关性。 方法将携带HBV且合并NAFLD的68例患者设为NAFLD组，另将具可比性的携带HBV而未合并NAFLD(NNAFLD)的76例设为NNAFLD组。比较2组血压、BMI、腰臀比、空腹血糖、空腹胰岛素、总胆固醇、甘油三酯、ALT、谷氨酰转移酶(γ-GGT)、CRP、血尿酸、HBV DNA定量以及反映胰岛素抵抗情况的稳态模型评估的胰岛素抵抗指数(HOMA-IR)。采用Logistic回归对NAFLD与年龄、性别、BMI、腰臀比、空腹血糖、空腹胰岛素、甘油三酯、总胆固醇、ALT、γ-GGT、CRP、血尿酸、HBV-DNA定量及HOMA-IR等因素的相关性进行分析。 结果NAFLD组的血压、BMI、腰臀比、空腹血糖、空腹胰岛素、甘油三酯、总胆固醇、LDL-C、ALT、γ-GGT、CRP、血尿酸和HOMA-IR均高于NNAFLD组，2组比较差异均有统计学意义(P均0.05)。 HOMA-IR、腰臀比、甘油三酯、总胆固醇进入Logistic回归方程，与NAFLD的发生相关。 结论HOMA-IR可能与HBV携带者发生NAFLD有关，HBV DNA定量可能与此类患者发生NAFLD无明显相关性。

    【关键词】胰岛素抵抗；非酒精性脂肪肝；HBV携带者

    DOI:10.3969/g.issn.0253-9802.2015.02.007

    收稿日期：(2014-09-28)

    Relationship of insulin resistance with hepatitis B virus asymptomatic carriers complicated with non-alcoholic fatty liver diseaseZengChunping,ChenYouping,LiuShuai,ShuYi,LiangYunyi.Departmentofendocrinology,NanhaiHospitalAffiliatedtotheSouthernMedicalUniversity,Foshan528200，China

    Abstract【】ObjectiveTo discuss the correlation between insulin resistance (IR) and the incidence of non-alcoholic fatty liver disease (NAFLD) in hepatitis B virus asymptomatic carriers. MethodsSixty-eight patients carrying HBV complicated with NAFLD were allocated into the NAFLD group. Seventy-six HBV carriers without NAFLD were enrolled in the NNAFLD group. The blood pressure, BMI, waist to hip ratio, fasting blood-glucose, fasting insulin, total cholesterol, triglyceride, ALT, glutamyltransferase (γ-GGT), CRP, blood uric acid, quantitative PCR detection of HBV DNA and homeostasis model assessment-estimated insulin resistance index (HOMA-IR) were measured and statistically compared between two groups. Logistic regression was adopted to analyze the correlation between NAFLD and age, gender, BMI, waist to hip ratio, fasting blood-glucose, fasting insulin, triglyceride, total cholesterol, ALT, γ-GGT, CRP, blood uric acid, quantitative PCR detection of HBV DNA and HOMA-IR. ResultsThe blood pressure, BMI, waist to hip ratio, fasting blood-glucose, fasting insulin, triglyceride, total cholesterol, LDL-C, ALT, γ-GGT,CRP and HOMA-IR in the NAFLD group were significantly higher compared with those in the NNAFLD group (all P0.05). Logistic regression revealed that HOMA-IR, waist to hip ratio, triglyceride and total cholesterol were correlated with the incidence of NAFLD. ConclusionsHOMA-IR is probably correlated with the incidence of NAFLD in HBV carriers. Quantitative determination of HBV DNA possibly has no significant correlation with the incidence of NAFLD in these patients. ......