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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.。
Objective To investigate the effect of nutritional intervention combined with aerobic exercise on serum leptin levels and insulin resistance (IR) in patients with nonalcoholic fatty liver disease (NAFL). Methods 42 cases of NAFL patients diagnosed by Liaocheng People’s Hospital Examination Center and Hepatopathy Clinic from August 2010 to August 2013 were NAFL group and 40 healthy people were selected as the control group in the same period. Nutritional intervention and aerobic exercise regimen were performed in the NAFL group. Body mass, body mass index (BMI), WHR, serum leptin, fasting blood glucose (FBG), fasting insulin (FINS) (HOMA-IR) were calculated. The differences between groups before intervention, the differences before and after the intervention of NAFL group, and the correlation between serum leptin and each index were also analyzed. Results The levels of body weight, BMI, WHR, FBG, FINS and leptin in NAFL group were significantly lower than those before intervention (P <0.01); HOMA-IR was lower than that before intervention, and the difference was not statistically significant P> 0.05). There was a significant positive correlation between leptin and BMI, FBG, FINS, HOMA-IR, TC and TG (P <0.01) and no correlation with HDL-C (P = 0.238). Conclusion Nutritional intervention combined with aerobic exercise can increase serum leptin levels, regulate blood glucose and lipid levels, and improve IR in NAFL patients.