肥胖个体血浆脂联素浓度降低与非酒精性肝脂肪变性密切相关。

Decreased plasma adiponectin concentrations are closely associated with nonalcoholic hepatic steatosis in obese individuals.

作者信息

Targher Giovanni, Bertolini Lorenzo, Scala Luca, Poli Felice, Zenari Luciano, Falezza Giancarlo

机构信息

Department of Internal Medicine, Sacro Cuore Hospital, 37024 Negrar (VR), Italy.

出版信息

Clin Endocrinol (Oxf). 2004 Dec;61(6):700-3. doi: 10.1111/j.1365-2265.2004.02151.x.

DOI:10.1111/j.1365-2265.2004.02151.x

PMID:15579183

Abstract

OBJECTIVES

To evaluate whether subjects with nonalcoholic hepatic steatosis (HS) differed in their circulating adiponectin levels compared with those in subjects without HS and, if so, to examine to what extent such differences are mediated by the adverse pattern of the metabolic syndrome variables, typically observed in these subjects.

DESIGN AND PATIENTS

In a cross-sectional study, we analysed 68 healthy, mildly obese individuals with a negative or negligible daily alcohol consumption.

MEASUREMENTS

HS (by ultrasonography), glucose tolerance status (by oral glucose load), insulin resistance [by homeostasis model assessment (HOMA)], and plasma adiponectin concentration [by enzyme-linked immunosorbent assay (ELISA)] were measured.

RESULTS

Subjects with nonalcoholic HS (n = 43) had markedly lower plasma adiponectin concentrations than those without HS (n = 25) (5.6 +/- 3 vs. 10.8 +/- 4 microg/ml; P < 0.001). In addition, the former had significantly higher values for body mass index (BMI), waist/hip ratio (WHR), HOMA-insulin resistance score, plasma insulin (at fasting and after glucose load), plasma triglyceride and liver enzyme concentrations [such as alanine aminotransferase (ALT) and gamma-glutamyltranspeptidase (GGT)], and tended to have lower high density lipoprotein (HDL) cholesterol concentration. The significant differences in plasma adiponectin levels that were observed between the groups were little affected by adjustment for potential confounding variables, such as age, sex, BMI, WHR, lipids and HOMA-insulin resistance score. Similarly, in multivariate regression analyses, hypoadiponectinaemia significantly predicted the presence of HS (P < 0.001) and the increased levels of GGT and ALT (P < 0.05), independently of potential confounders.

CONCLUSIONS

These results show that decreased plasma adiponectin concentrations are closely correlated with nonalcoholic HS in healthy obese individuals.

摘要

目的

评估非酒精性肝脂肪变性（HS）患者与无HS患者相比，其循环脂联素水平是否存在差异；若存在差异，则探究这种差异在多大程度上由代谢综合征变量的不良模式介导，这些不良模式在这些患者中较为常见。

设计与患者

在一项横断面研究中，我们分析了68名健康的轻度肥胖个体，他们每日酒精摄入量为阴性或可忽略不计。

测量指标

测量HS（通过超声检查）、糖耐量状态（通过口服葡萄糖负荷试验）、胰岛素抵抗[通过稳态模型评估（HOMA）]以及血浆脂联素浓度[通过酶联免疫吸附测定（ELISA）]。

结果

非酒精性HS患者（n = 43）的血浆脂联素浓度明显低于无HS患者（n = 25）（5.6±3 vs. 10.8±4μg/ml；P < 0.001）。此外，前者的体重指数（BMI）、腰臀比（WHR）、HOMA胰岛素抵抗评分、血浆胰岛素（空腹及葡萄糖负荷后）、血浆甘油三酯和肝酶浓度[如丙氨酸氨基转移酶（ALT）和γ-谷氨酰转肽酶（GGT）]显著更高，且高密度脂蛋白（HDL）胆固醇浓度往往更低。在对年龄、性别、BMI、WHR、血脂和HOMA胰岛素抵抗评分等潜在混杂变量进行校正后，两组间观察到的血浆脂联素水平的显著差异几乎未受影响。同样，在多变量回归分析中，低脂联素血症显著预测了HS的存在（P < 0.001）以及GGT和ALT水平的升高（P < 0.05），且不受潜在混杂因素的影响。