营养干预结合有氧运动对非酒精性单纯性脂肪肝患者血清瘦素水平的影响

摘要:目的　探讨营养干预结合有氧运动对非酒精性单纯性脂肪肝（NAFL）患者血清瘦素水平和胰岛素抵抗（IR）的影响。方法　以2010年8月-2013年8月聊城市人民医院查体中心和肝病门诊确诊的NAFL患者42例为NAFL组，同期健康查体人员40例为对照组。对NAFL组进行营养干预并实施有氧运动方案，检测两组干预前后体重、体重指数（BMI）、腰臀比（WHR）、血清瘦素、空腹血糖（FBG）、空腹胰岛素（FINS）及血脂水平变化，计算胰岛素抵抗指数（HOMA-IR），比较干预前组间差异、NAFL组干预前后差异以及血清瘦素与各指标的相关性。结果　NAFL组干预后体重、BMI、WHR、FBG、FINS和瘦素水平低于干预前，差异有统计学意义（P＜0.01）；HOMA-IR较干预前有所降低，差异无统计学意义（P＞0.05）。瘦素与BMI、FBG、FINS、HOMA-IR、TC和TG呈显著正相关（P＜0.01），与HDL-C无相关性（P＝0.238）。结论　营养干预结合有氧运动可提高NAFL患者的血清瘦素水平，调节血糖血脂水平，改善IR.。

Influences of nutritional intervention combined with aerobic exercises on serum leptin of nonalcoholic fatty liver patients

Abstract: Objective To study the influences of nutritional intervention combined with aerobic exercises on serum leptin and insulin resistant of nonalcoholic fatty liver patients. Methods 42 patients with non- alcoholic fatty liver were recruited as the NAFL group and 40 health people were recruited as the control group. The changes of weight, BMI, WHR, serum leptin, fasting blood glucose (FBG), fasting insulin (FINS) and serum lipids were recorded before and after interventions, and insulin resistance index (HOMA-IR) was calculated. We compared the difference between groups before intervention, difference before and after the intervention in NAFL group, and the correlation of the serum leptin and other indexes. Results The weight, BMI, WHR, FBG, FINS and the leptin of NAFL group were significantly lower than those before the intervention, and the difference was statistically significant (P<0.001). The HOMA-IR was lower than that before the intervention, while there was no statistically significant (P>0.05). Serum leptin was positively correlated with BMI, FBG, FINS, HOMA-IR, TG and TC (P<0.001), while there was no correlation between serum leptin and HDL-C (P=0.238). Conclusion Nutritional intervention combines with aerobic exercises can increase the level of serum leptin in NAFL patients, and also adjust the level of serum glucose, serum lipids and IR.