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肝硬化和慢性病毒性肝炎患者的血清瘦素水平

Serum leptin levels in patients with liver cirrhosis and chronic viral hepatitis.

作者信息

Comlekci A, Akpinar H, Yesil S, Okan I, Ellidokuz E, Okan A, Ersoz G, Tankurt E, Batur Y

机构信息

Dokuz Eylül University Medical School, Dept. of Internal Medicine, Division of Endocrinology, Inciralti, Turkey.

出版信息

Scand J Gastroenterol. 2003 Jul;38(7):779-86. doi: 10.1080/00365520310003877.

Abstract

BACKGROUND

The aim of the present study was to investigate serum leptin levels in relation to anthropometric features in patients with liver cirrhosis (LC) and chronic viral hepatitis (CVH), and to determine the effect of the severity and aetiology of the LC on serum leptin levels.

METHODS

Forty-nine patients with LC, 32 patients with CVH and 69 control subjects were age, body mass index (BMI) and sex-matched and included in the study. Plasma glucose, serum leptin and insulin levels were determined. Insulin resistance was assessed using homoeostasis model assessment (HOMA). Body composition was estimated by skinfold thickness.

RESULTS

Female patients with Child-A LC had higher levels of leptin, and female and male patients with Child-A LC had higher absolute leptin (leptin/BFM) levels compared to patients with Child-C LC and control subjects. Serum leptin levels of the patients with alcohol LC were higher than the control subjects, but the absolute leptin levels were comparable. When alcoholic and post-viral hepatitis cirrhotic patients were compared with each other on an aetiologic basis, there was no significant difference between them in leptin and absolute leptin levels. There were significant correlations between leptin and BMI, body fat percentage (BFP), BFM (body fat mass) in all three groups in both sexes.

CONCLUSIONS

These data suggest that the physiologic correlations among serum leptin level, sex, BMI and BFM were well preserved in patients with chronic liver disease. Patients with alcohol LC had higher leptin levels. In early stages of liver disease, leptin levels and absolute leptin levels are higher than in normal subjects. However, in advanced stages of the disease the significant decline in leptin levels and similar levels of leptin expressed in relation to BFM compared to control subjects predominantly represent the expression of fat mass.

摘要

背景

本研究旨在调查肝硬化(LC)和慢性病毒性肝炎(CVH)患者血清瘦素水平与人体测量学特征的关系,并确定LC的严重程度和病因对血清瘦素水平的影响。

方法

49例LC患者、32例CVH患者和69例对照者按年龄、体重指数(BMI)和性别匹配后纳入研究。测定血浆葡萄糖、血清瘦素和胰岛素水平。采用稳态模型评估(HOMA)评估胰岛素抵抗。通过皮褶厚度估计身体成分。

结果

Child-A级LC的女性患者瘦素水平较高,与Child-C级LC患者和对照者相比,Child-A级LC的女性和男性患者的绝对瘦素(瘦素/体脂质量)水平更高。酒精性LC患者的血清瘦素水平高于对照者,但绝对瘦素水平相当。在病因学基础上比较酒精性和病毒感染后肝炎肝硬化患者时,他们的瘦素和绝对瘦素水平无显著差异。在所有三组的男女中,瘦素与BMI、体脂百分比(BFP)、体脂质量(BFM)之间均存在显著相关性。

结论

这些数据表明,血清瘦素水平、性别、BMI和BFM之间的生理相关性在慢性肝病患者中得到了很好的保留。酒精性LC患者的瘦素水平较高。在肝病早期,瘦素水平和绝对瘦素水平高于正常受试者。然而,在疾病晚期,与对照者相比,瘦素水平显著下降,且与BFM相关的瘦素水平相似,这主要代表了体脂量的表达。

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