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儿童肥胖非酒精性脂肪肝胰岛β细胞功能的研究

于阿莉1,刘戈力2,杨箐岩1,郑荣秀1,鲍鹏丽1,高芳芳1   

  1. 1. 天津医科大学总医院
    2. 天津医科大学总医院儿科
  • 收稿日期:2011-12-05 修回日期:2012-01-31 出版日期:2012-11-15 发布日期:2012-11-15
  • 通讯作者: 于阿莉

Study of islet βcell function in obese children with nonalcoholic fatty liver disease.

  • Received:2011-12-05 Revised:2012-01-31 Published:2012-11-15 Online:2012-11-15
  • Contact: A-Li YU

摘要: 【摘要】目的 探讨儿童肥胖非酒精性脂肪肝的胰岛β细胞功能。方法 对2007年6月-2011年4月天津医科大学总医院儿科内分泌门诊就诊的362例肥胖儿童,经腹部B超检查分为伴有非酒精性脂肪肝(NAFLD)组170例及不伴非酒精性脂肪肝且肝功能正常的单纯肥胖组192例,164例正常查体体重正常的儿童作为对照组;所有儿童进行血甘油三酯、胆固醇、空腹血糖(FPG)及空腹胰岛素(FINS)、HbA1c的检测;肥胖儿童行口服葡萄糖耐量及胰岛素释放试验。计算胰岛素敏感指数(QUICKI法),胰岛素抵抗指数(HOMA-IR),胰岛β细胞功能指数(HOMA-β)。结果 NAFLD组FPG、FINS、胰岛素抵抗指数、胰岛β细胞功能指数及HbA1c明显高于无NAFL组及对照组(P<0.05);NAFDL组胰岛素敏感指数明显低于无NAFLD组及对照组(p<0.05);NAFLD组糖代谢异常检出率明显高于无NAFLD组(p<0.05)。结论 儿童肥胖非酒精性脂肪肝患儿存在胰岛β细胞功能受损和糖脂代谢异常,胰岛β细胞功能受损可能是儿童非酒精性脂肪肝的发病机制之一。

关键词: 非酒精性脂肪肝, 肥胖, 儿童, 胰岛β细胞功能, 糖化血红蛋白

Abstract: Abstract: Objectives To investigate islet βcell function in obese children with nonalcoholic fatty liver disease . Methods Three hundred and sixty-two obese children and one hundred and sixty-four normal children were enrolled in the study form June 2007 to April 2011. 170 of the obese children accompanied with NAFLD , 192 simple obese children without NAFLD. Triglycerides、cholesterol、fasting plasma glucose(FPG)、fasting insulin(FINS)、HbA1c were assayed in these children. Oral glucose tolerance test and insulin releasing test were performed in all obese children. The homeostasis model assessment – insulin resistance(HOMA-IR) ,insulin sensitivity index (QUICKI) and β-cell function index (HOMA-β) were calculated. Results FPG、FINS、HbA1c、HOMA-β and HOMA-IR in NAFL group were significantly higher than the other two groups(P<0.05); QUICKI in NAFLD group was significantly lower than the other two groups (P<0.05). The relevance ratio of abnormal glucose metabolism in NAFLD group was significantly higer than without NAFLD group(P<0.05). Obese children with nonalcoholic fatty liver disease existed impaired function of islet β-cell and glucolipid metabolism disorders. The impaired function of islet β-cell could be one of the pathogenesis for nonalcoholic fatty liver disease.

Key words: nonalcoholic fatty liver disease, obsess, children, islet βcell function, HbA1c