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Correlation of liver fat content with serum vitamin A level and insulin resistance in patients with nonalcoholic fatty liver disease
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摘要:
目的观察和分析非酒精性脂肪性肝病（NAFLD）患者肝脏脂肪含量（LFC）与血清维生素A（VA）水平及胰岛素抵抗（IR）之间的关系。方法征集2016年2月-2017年1月上海市崇明地区初诊NAFLD患者200例和健康志愿者98例。根据口服75 g葡萄糖耐量试验和胰岛素释放试验,将NAFLD患者分为单纯NAFLD组（n=91）、NAFLD合并糖调节受损（IGR）组（n=69）,NAFLD合并2型糖尿病（T2DM）组（n=40）,另将98例健康志愿者作为健康对照组。用稳态模型评估IR,用高效液相色谱法检测血清VA水平,采用3.0 T质子磁共振波谱进行LFC检测。符合正态分布的计量资料多组间比较采用单因素方差分析,进一步两两比较采用LSD-t检验;不符合正态分布的计量资料组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Mann-Whitmey U检验。计数资料组间比较采用Pearsonχ2检验。相关性分析采用Spearman相关性分析法。结果健康对照组、单纯NAFLD组、NAFLD合并IGR组和NAFLD合并T2DM组4组间FPG、葡萄糖耐量试验负荷后2 h血糖（2h PG...
Abstract:Objective To investigate the correlation of liver fat content ( LFC) with serum vitamin A ( VA) level and insulin resistance ( IR) in patients with nonalcoholic fatty liver disease ( NAFLD) . Methods A total of 200 patients with an initial diagnosis of NAFLD in Shanghai Chongming from February 2016 to January 2017 were enrolled. According to the results of oral glucose tolerance test with 75 g glucose and insulin releasing test, NAFLD patients were divided into simple NAFLD group with 91 patients, NAFLD-impaired glucose regulation ( IGR) group with 69 patients, and NAFLD-type 2 diabetes mellitus ( T2 DM) group with 40 patients. A total of 98 healthy volunteers were enrolled as healthy control group. The homeostasis model was used to evaluate IR, high-performance liquid chromatography was used to measure serum VA level, and 3. 0 T1 H-magnetic resonance spectroscopy was used to measure LFC. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the LSD-t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitmey U test was used for further comparison between two groups. The Pearson's chi-squared test was used for comparison of categorical data between groups. A Spearman correlation analysis was also performed. Results There were significant differences in fasting plasma glucose ( FPG) , 2-hour postprandial glucose ( 2 h PG) , and Hb Alc between the healthy control group, simple NAFLD group, NAFLD-IGR group, and NAFLD-T2 DM group ( F = 303. 8, 133. 1, and 249. 3, all P < 0. 01) . The simple NAFLD group, NAFLD-IGR group, and NAFLD-T2 DM group had significant increases in FPG, 2 h PG, and Hb Alc ( all P < 0. 01) , and compared with the simple NAFLD group, NAFLD-IGR group, and NAFLD-T2 DM group, the healthy control group had significant reductions in body mass index, alanine aminotransferase, triglyceride, and low-density lipoprotein ( all P < 0. 01) . The simple NAFLD group, NAFLD-IGR group, and NAFLD-T2 DM group had significantly higher serum VA level, LFC, and HOMA2-IR than the healthy control group ( F = 9. 2, H = 216. 1, and H = 151. 0, all P < 0. 01) . HOMA2-IR and LFC gradually increased in the simple NAFLD group, NAFLD-IGR group, and NAFLD-T2 DM group ( H = 26. 7 and 38. 6, both P < 0. 01) . There were significant differences in HOMA2-IR and LFC between the NAFLD-IGR group and the NAFLD-T2 DM group ( U = 995 and 800, both P < 0. 01) ; there were also significant differences in HOMA2-IR, LFC, and VA between the NAFLD-IGR group and the simple NAFLD group, as well as between the NAFLD-T2 DM group and the simple NAFLD group ( all P < 0. 05) . LFC was positively correlated with VA ( R2= 0. 103, P < 0. 001) and HOMA2-IR ( R2= 0. 531, P < 0. 001) . Conclusion The increase in LFC is closely associated with high serum VA level and disorder of glucose metabolism in patients with NAFLD.
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Key words:
- nonalcoholic fatty liver disease /
- vitamin A /
- liver fat content /
- insulin resistance
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