Haukeland John Willy, Damås Jan Kristian, Konopski Zbigniew, Løberg Else Marit, Haaland Terese, Goverud Ingeborg, Torjesen Peter A, Birkeland Kåre, Bjøro Kristian, Aukrust Pål
Faculty Division, Aker University Hospital, University of Oslo, Oslo, Norway.
J Hepatol. 2006 Jun;44(6):1167-74. doi: 10.1016/j.jhep.2006.02.011. Epub 2006 Mar 20.
BACKGROUND/AIMS: To elucidate the role of systemic inflammation in nonalcoholic fatty liver disease (NAFLD).
Serum samples in 47 patients with histologically verified NAFLD (22 with simple steatosis and 25 with nonalcoholic steatohepatitis [NASH]), and in 30 age-, sex- and ethnicity-matched healthy controls, were assessed for (i) general markers of inflammation (C-reactive protein [CRP], tumor necrosis factor [TNF]-alpha, and interleukin [IL]-6), (ii) chemokines (CC-chemokine ligand [CCL] 2/monocyte chemoattractant protein [MCP]-1, CCL19 and CCL21), (iii) adipocytokines related to insulin resistance and inflammation (adiponectin and leptin) and (iv) a marker of oxidative stress (8-isoprostane-F2alpha).
Serum levels of several inflammatory cytokines were increased in NAFLD as compared to controls, and IL-6 (P=0.017), CCL2/MCP-1 (P=0.008) and CCL19 (P=0.001), but not CRP (P=0.199), remained elevated also after correction for sex, body mass index (BMI) and age. Comparing NASH with simple steatosis, levels of TNF-alpha (P=0.024) and CCL2/MCP-1 (P=0.012) were elevated and adiponectin (in women) (P=0.001) were decreased also after adjustment for sex, BMI and presence of the metabolic syndrome.
Our results indicate that patients with NAFLD are characterized by a low-grade systemic inflammation. The high CCL2/MCP-1 levels in NASH might be of importance for the conversion from simple steatosis to NASH.
背景/目的：阐明全身炎症在非酒精性脂肪性肝病（NAFLD）中的作用。
对47例经组织学证实的NAFLD患者（22例为单纯性脂肪变性，25例为非酒精性脂肪性肝炎[NASH]）以及30例年龄、性别和种族匹配的健康对照者的血清样本进行评估，检测指标包括：（i）炎症的一般标志物（C反应蛋白[CRP]、肿瘤坏死因子[TNF]-α和白细胞介素[IL]-6）；（ii）趋化因子（CC趋化因子配体[CCL]2/单核细胞趋化蛋白[MCP]-1、CCL19和CCL21）；（iii）与胰岛素抵抗和炎症相关的脂肪细胞因子（脂联素和瘦素）；（iv）氧化应激标志物（8-异前列腺素-F2α）。
与对照组相比，NAFLD患者血清中几种炎症细胞因子水平升高，在校正性别、体重指数（BMI）和年龄后，IL-6（P = 0.017）、CCL2/MCP-1（P = 0.008）和CCL19（P = 0.001）仍保持升高，而CRP（P = 0.199）未升高。将NASH与单纯性脂肪变性进行比较，在校正性别、BMI和代谢综合征的存在后，TNF-α（P = 0.024）和CCL2/MCP-1（P = 0.012）水平升高，脂联素（女性）（P = 0.001）水平降低。
我们的结果表明，NAFLD患者的特征是存在低度全身炎症。NASH中CCL2/MCP-1水平升高可能对从单纯性脂肪变性转变为NASH具有重要意义。
