绝经后女性非酒精性脂肪性肝病患者性激素水平与胰岛素抵抗 肝酶学异常的关系
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摘要
目的探讨绝经后女性非酒精性脂肪性肝病(NAFLD)患者性激素水平与胰岛素抵抗、肝酶学异常的关系。方法回顾性分析本院2017年3月至2019年3月治疗的96例绝经后女性NAFLD患者的临床资料,设为观察组,并选择100名同年龄段绝经后健康女性为对照组,通过化学发光法测定血清总睾酮(TT)、雌二醇(E2)和胰岛素(INS),通过酶联免疫分析法测定血清雌酮(E1),胰岛素抵抗指数(HOMA-IR)评价用稳态模型,肝肾功能及血脂水平测定用全自动生化分析仪,对2组TT、E1、E2、INS、HOMA-IR指标进行比较。结果观察组患者天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)水平与对照组相比差异无统计学意义(P>0.05),丙氨酸转氨酶(ALT)、谷氨酰转肽酶(GGT)水平与健康对照组,差异有统计学意义(P<0.05);观察组患者INS、HOMA-IR明显高于对照组,血清TT明显低于对照组,差异有统计学意义(P<0.05);2组E2、血清E1水平比较差异无统计学意义(P>0.05)。结论绝经后女性NAFLD患者TT、E1、E2和HOMA-IR可能有负相关关系,和ALT、GGT水平可能有正相关关系,且与NAFLD的肝酶学异常紧密相关,可用于指导临床诊断与治疗。
Objective To investigate the relationship between sex hormone levels and insulin resistance and liver enzyme abnormalities in postmenopausal women with NAFLD. Methods We retrospectively analyzed 96 patients of postmenopausal women with NAFLD during the period from March 2017 to March 2019 in the Third People ′s Hospital of Shenzhen,and 100 postmenopausal healthy women matched with age were selected as control group.Serum total testosterone(TT), estradiol(E2), insulin(INS), estrone(E1), liver and kidney function and blood lipid levels were measured, and insulin resistance index(HOMA-IR) was evaluated using a steady-state model. Then we analyzed the indicators by Mann-Whitney test. Results Compared with the control group, there was no difference in the levels of aspartate aminotransferase(AST) and alkaline phosphatase(ALP) in the observation group(P>0.05), but the levels of alanine aminotransferase(ALT) and glutamyltranspeptidase(GGT) were significantly higher(P<0.05). The INS and HOMA-IR of the observation group were higher than that of the control group, and the serum total testosterone was lower than that of the control group, the difference was statistically significant(P<0.05), but there was no significant difference in the serum levels of estradiol and estrone between the two groups(P>0.05). Conclusion We found a negative correlation between TT, E1, E2 and insulin resistance index in postmenopausal women with NAFLD, but positive correlation with ALT and GGT levels, and they were related to liver enzyme abnormalities of NAFLD, which can be used to guide clinical diagnosis and treatment in the future.
Objective To investigate the relationship between sex hormone levels and insulin resistance and liver enzyme abnormalities in postmenopausal women with NAFLD. Methods We retrospectively analyzed 96 patients of postmenopausal women with NAFLD during the period from March 2017 to March 2019 in the Third People ′s Hospital of Shenzhen,and 100 postmenopausal healthy women matched with age were selected as control group.Serum total testosterone(TT), estradiol(E2), insulin(INS), estrone(E1), liver and kidney function and blood lipid levels were measured, and insulin resistance index(HOMA-IR) was evaluated using a steady-state model. Then we analyzed the indicators by Mann-Whitney test. Results Compared with the control group, there was no difference in the levels of aspartate aminotransferase(AST) and alkaline phosphatase(ALP) in the observation group(P>0.05), but the levels of alanine aminotransferase(ALT) and glutamyltranspeptidase(GGT) were significantly higher(P<0.05). The INS and HOMA-IR of the observation group were higher than that of the control group, and the serum total testosterone was lower than that of the control group, the difference was statistically significant(P<0.05), but there was no significant difference in the serum levels of estradiol and estrone between the two groups(P>0.05). Conclusion We found a negative correlation between TT, E1, E2 and insulin resistance index in postmenopausal women with NAFLD, but positive correlation with ALT and GGT levels, and they were related to liver enzyme abnormalities of NAFLD, which can be used to guide clinical diagnosis and treatment in the future.
引文
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