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目的 探讨α亚麻酸(ALA)治疗对肥胖患者胰岛素敏感性的影响.方法 2011年10月至2012年4月,于山西医科大学第二医院门诊就诊的16例肥胖患者采用ALA口服治疗8周,行前瞻性研究.治疗前后行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验检查,采用稳态模型评估的胰岛素抵抗指数(HOMA-IR)和OGTT胰岛素曲线下面积(AUCI)评价其胰岛素敏感性,并测定空腹甘油三酯、血游离脂肪酸(FFA)、白细胞介素(IL)6及肿瘤坏死因子(TNF)α水平.结果 肥胖组空腹胰岛素、HOMA-IR、甘油三酯、FFA、IL-6及TNF-α较正常对照组均明显增高(均P＜0.05)；肥胖组经ALA治疗后空腹胰岛素、甘油三酯、FFA、IL-6及TNF-α较治疗前明显降低(P＜0.05),HOMA-IR及AUCI较治疗前明显降低(HOMA-IR:1.8±0.2比1.2±0.3,P＜0.05;AUCI:1151±505比768±347,P＜0.05).结论 ALA治疗可显著改善肥胖患者的胰岛素敏感性,可能有助于2型糖尿病和动脉粥样硬化性心血管疾病的防治.

Objective To explore the effects of α-linolenic acid on insulin sensitivity in obese patients.Methods From October 2011 to April 2012,16 patients received an oral dose of α-linolenic acid for 8 weeks.Oral glucose tolerance test (OGTT)and insulin releasing test were performed before and after treatment.Homeostasis model assessment insulin resistance (HOMA-IR)index and area under curve of insulin (AUCI)were calculated to evaluate the insulin sensitivity.The levels of serum triglyceride,free fatty acids (FFA),interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured after an overnight fast.Results Obese patients had significantly elevated serum insulin,triglyceride,FFA,IL-6 and TNF-α versus the subjects in normal control group (all P ＜ 0.05).Obese patients were also more insulinresistant than normal subjects based on a higher HOMA-IR (P ＜ 0.05).Decreased serum insulin,triglyceride,FFA,IL-6 and TNF-α were observed after treatment.With the administration of α-linolenic acid,HOMA-IR and AUCI significantly decreased in obese patients (HOMA-IR:1.8 ± 0.2 vs 1.2 ± 0.3,P＜0.05; AUCI:1151 ±505 vs 768 ±347,P＜0.05).Conclusion α-linolenic acid increases peripheral insulin sensitivity in obese patients and it may aid the prevention and treatment of type 2 diabetes mellitus and atherosclerotic vascular diseases.