非酒精性脂肪性肝病进展性肝纤维化患者空腹血糖受损和胰岛素抵抗调查*

doi:10.3969/j.issn.1672-5069.2022.06.014

Abstract

Abstract: Objective The aim of this study was to analyze the impact of impaired fasting glucose (IFG) and insulin resistance (IR) on liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 110 patients with NAFLD were encountered in the Health Management Clinic between May 2020 and May 2021. All individuals underwent oral glucose tolerance test (OGTT), and the homeostasis model insulin resistance index (HOMA-IR) was calculated. Serum type IV collagen, type III procollagen (PCIII), laminin (LN) and hyaluronic acid (HA) levels were detected by radioimmunoassay. The NAFLD fibrosis score (NFS) was calculated and the progressive liver fibrosis (PLF) was defined as the NFS﹥0.676. The multivariate Logistic regression analysis was applied to reveal the risk factors for PLF occurrence. Results Based on the OGTT results, the normal glucose tolerance (NGT) was found in 43 cases, the impaired glucose tolerance (IGT) in 35 cases and the IFG in 32 cases; the fasting plasma glucose, insulin and HOMA-IR in patients with IFG were (6.6±0.3) mmol/L, (10.9±2.4) μU/mL and 3.2±0.9, significantly higher than [(5.6±0.7) mmol/L, (8.5±2.2) μU/mL and 2.4±0.5, P<0.05] in patients with IGT or [(5.5±0.6) mmol/L, (7.4±1.9) μU/mL and 1.8±0.4, P<0.05] in patients with NGT; serum collagen IV, PCIII, LN and HA levels in patients with IFG were (75.7±9.6) ng/mL, (146.3±13.1) ng/mL, (132.7±15.2) ng/mL and (189.6±17.5) ng/mL, significantly higher than [(63.9 ± 8.4) ng/mL, (133.3 ± 10.7) ng/mL, (122.4 ± 13.4) ng/mL and (163.9 ± 18.6) ng/mL, P<0.05] in patients with IGT or [(59.4 ± 7.4) ng/mL, (128.6 ± 11.6) ng/mL, (109.4 ± 8.9) ng/mL and (150.2 ± 13.2) ng/mL, P<0.05] in patients with NGT; the PLF was found in 18 patients in our series, and the multivariate Logistic regression analysis showed that the IFG (OR=1.528) and IR (OR=1.714) were the independent risk factors for PLF in patients with NAFLD (P<0.05). Conclusion When the IFG occurs in patients with NAFLD hint the IR, which might promote liver fibrosis progression.

Key words: Nonalcoholic fatty liver disease, Impaired fasting glucose, Insulin resistance, Liver fibrosis

Wang Xiaohua, Zeng Yalin, Guo Cuirong. Impact of impaired fasting glucose and insulin resistance on liver fibrosis in patients with nonalcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2022, 25(6): 812-815.

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Impact of impaired fasting glucose and insulin resistance on liver fibrosis in patients with nonalcoholic fatty liver diseases

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