A Preliminary Study on Insulin Resistance and the Familial Clustering Phenomena of Primary Fatty Liver Disease_West China Medical Journal

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Department of Endocrinology,West China Hospital,Sichuan University,Chengdu,610041 China;

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Keywords：

原发性脂肪肝; 胰岛素抵抗; 一级亲属; 家族集聚现象

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目的：对原发性脂肪肝（PFLD）患者及健康对照的一级亲属中PFLD发生情况、胰岛素抵抗（HOMA-IR）指数以及其他相关代谢指标的测定，了解PFLD是否有家族集聚现象及IR在其发病中的可能作用。方法：PFLD的诊断依据B超为脂肪肝并排除继发性原因。PFLD家系组（A组）共42例，11个家庭。选取与A组年龄、性别构成及生活方式和经济状况相近的健康志愿者家系为对照组（B组）共14例，4个家庭。所有受试者均进行身高、体重、腰围、血压等测定，行糖耐量试验、胰岛素及血脂质等检测，并对受试者的生活方式及文化程度和经济状况行量化打分。结果：A组PFLD 33例（78.57%，A1组），无脂肪肝9例（A2组），说明有家族集聚现象。与B组相比，A1组的体重指数、腰围、舒张压、血总胆固醇和HOMA-IR指数显著高于B组（P＜0.05）；血高密度脂蛋白胆固醇（HDL-C）显著低于B（P＜0.05）；A2组的各项指标与B组相比差异无统计学意义，但变化趋势呈现出腹型肥胖、IR、代谢紊乱和血压偏高；而A1组及A2组与B组的生活方式及经济状况无明显差异。结论：PFLD具有较强的家族聚发现象，其IR程度显著高于对照组；家族中无脂肪肝者存在IR相关的代谢紊乱趋势。说明某种内在或遗传因素如IR可能与PFLD发病有关。

Citation： WANG Xiaoqian,TONG Nanwei. A Preliminary Study on Insulin Resistance and the Familial Clustering Phenomena of Primary Fatty Liver Disease. West China Medical Journal, 2008, 23(1): 45-47. doi: Copy

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1.
2. of overweight to prevent metabolic syndrome in elder Japanese workers[J].J Occup Health,2003,45:335-343.
3. LoriaP,Lonardo A,Carulin N,et al.Should nonalcoholic fatty liver disease be renamed[J]?Dig Dis,2005,23:72-82.
4. Carol M,Ruma CK,Stephanic R,Wilson J.Diagnostic Ultrasound[M].A Harcourt Health Sciences Company,Westline Industrial Drive St.Louis Missouri.1998.
5. 中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪肝诊断标准[J].中华肝脏病杂志,2003,11:71.
6. Anuurad E,Shiwaku K,Nogi A,et al.The new BMI criteria for Ascians by the regional office for the western pacific region of WHO are suitable for screening.
7. Expert panel on Detection,Evaluation,and Treatment of High Blood Cholesterol in Adults.Executive Summary of The Third Report of The National Cholesterol Education Program(NCEP)Expert panel on Detection,Evaluation,and Treatment of High Blood Cholesterol in Adults(Adult Treatment Panel Ⅲ)[J].JAMA,2001,285:2486-2497.
8. Chobanian AV,Bakris GL,Black HR,et al.The seventh report of the joint national committee on prevention,detection,evaluation,and treatment of high blood pressure[J].JAMA,2003,289:2560-2572.
9. The expert committee on the diagnosis and classification of diabetes mellitus.Follow-up report on the diagnosis of diabetes mellitus[J].Diabetes Care,2003,26:3160-3167.
10. Matthews DR,Hosker JP,Rudenski AS,et al.Homeostasis model assessment:insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man[J].Diabetologia,1985,28:412-419.[9]Mc Cullough AJ.Update on nonalcoholic fatty liver disease[J].J Clin Gastroenterol,2002,34:255-262.

West China Medical Journal

A Preliminary Study on Insulin Resistance and the Familial Clustering Phenomena of Primary Fatty Liver Disease

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