中文摘要：

目的：探讨非酒精性脂肪肝（NAFLD）与超敏C反应蛋白（hsCRP）、胰岛素抵抗的关系。方法：从2006年10月至12月在湘雅二医院健康体检的长沙某企业职工中随机抽样，其中NAFLD组243例，无脂肪肝组361例，进行问卷调查、体格检查、空腹血糖、血脂、谷丙转氨酶（ALT）、血尿酸、空腹胰岛素和hsCRP检测以及腹部B超检查。结果：与轻度脂肪肝比较，中度脂肪肝血清hsCRP，胰岛素抵抗指数（HOMA—IR）增高显著（P〈0．01）。胰岛素抵抗NAFLD患者hsCRP，ALT水平明显高于无胰岛素抵抗患者（P〈0．05）。血清hsCRP高浓度组NAFLD患病风险是低浓度组的5．937倍。采用多因素logistic回归分析，调整了性别、年龄和多项代谢成分后，NAFLD与hsCRP，HOMA—IR独立相关（OR值分别为2．044，7．896，P〈0．01）。结论：血清hsCRP、胰岛素抵抗与NAFLD存在关联，是发生NAFLD的独立危险因素。全身系统性炎症和胰岛素抵抗在NAFLD发生发展中起重要作用。

英文摘要：

Objective To explore the relationship among non-acoholic fatty liver disease （NAFLD） , high sensitivity reactive C protein （hsCRP） and insulin resistance. Methods Workers of an enterprise in Changsha for health examination in Second Xiangya Hospital from October to December, 2006, NAFLD group （243 patients） and a control group without fatty liver disease （361 patients） were randomly drawn. Questionnaire, physical examination, fasting plasma glucose, serum lipid-profile, alanine aminotransferase （ALT） , blood uric acid, and abdominal uhrasonographic exmination were undertaken in the 2 groups. Results The moderate NAFLD group had significantly higher hsCRP concentration and homeostasis model assessment of insulin resistance （ HOMA-IR ） as compared with the mild NAFLD group （ P 〈0.01 ）. The patients with insulin resistance had significantly higher hsCRP concentration and ALT level compared with NAFLD patients without insulin resistance （ P 〈 0.05 ）. The NAFLD patients were divided into 2 groups （ low and high ） according to the hsCRP concentration （ 〈 1 mg/L or ≥ 1 mg/L）. Compared with the low concentration group, the odds ratio of the high concentration group for prevalence of NAFLD was 5. 937 （ P 〈 0. 001 ）. Multi-factor logistic regression analysis demonstrated that NAFLD was independently correlated with hsCRP or HOMA-IR after adjustment for sex, age and metabolic components （ OR = 2. 044, 7. 896, P 〈 0.01 ）. Conclusion NAFLD is closely correlated with hsCRP and HOMA-IR. Insulin resistance and elevated hsCRP concentration are the independent risk factors for the presence of NAFLD.