Targher Giovanni, Bertolini Lorenzo, Rodella Stefano, Zoppini Giacomo, Scala Luca, Zenari Luciano, Falezza Giancarlo
Division of Internal Medicine, Sacro Cuore Hospital, Negrar, Italy.
Clin Endocrinol (Oxf). 2006 Jun;64(6):679-83. doi: 10.1111/j.1365-2265.2006.02527.x.
To explore associations between plasma adiponectin concentrations and liver histology in patients with nonalcoholic fatty liver disease (NAFLD).
In a cross-sectional study, we enrolled 60 consecutive NAFLD patients and 60 age-, sex- and body mass index (BMI)-matched healthy controls.
NAFLD (by liver biopsy), plasma adiponectin concentrations, insulin resistance (by homeostasis model assessment, HOMA-IR) and metabolic syndrome (MetS) features.
NAFLD patients had a marked decrease in plasma adiponectin concentration (6.1 +/- 2.8 vs. 13.6 +/- 3.8 microg/ml, P < 0.001) compared with matched controls. MetS, as defined by the Adult Treatment Panel III (ATP III) criteria, and its individual components were more frequent among NAFLD patients. The marked differences in adiponectin concentrations that were observed between the groups were little affected by adjustment for age, sex, BMI, HOMA-IR score and MetS components. Notably, decreased adiponectin levels were closely associated with the degree of hepatic steatosis, necroinflammation and fibrosis (P < 0.001 for all) among NAFLD patients. By logistic regression analysis, low adiponectin levels independently predicted hepatic steatosis [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.5-5.8, P < 0.001] and necroinflammation (OR 3.1, 95% CI 1.9-7, P < 0.001), but not fibrosis (P = 0.07), after adjustment for age, sex, BMI, HOMA-IR and MetS components.
NAFLD patients have markedly lower plasma adiponectin concentrations than control subjects. Low adiponectin levels are strongly associated with the severity of liver histology, thus further supporting the hypothesis that adiponectin might be involved in the development of NAFLD.
探讨非酒精性脂肪性肝病（NAFLD）患者血浆脂联素浓度与肝脏组织学之间的关联。
在一项横断面研究中，我们连续纳入了60例NAFLD患者以及60例年龄、性别和体重指数（BMI）相匹配的健康对照者。
NAFLD（通过肝脏活检）、血浆脂联素浓度、胰岛素抵抗（通过稳态模型评估，HOMA-IR）以及代谢综合征（MetS）特征。
与匹配的对照组相比，NAFLD患者血浆脂联素浓度显著降低（6.1±2.8 vs. 13.6±3.8微克/毫升，P<0.001）。根据成人治疗小组第三次报告（ATP III）标准定义的MetS及其各个组分在NAFLD患者中更为常见。在对年龄、性别、BMI、HOMA-IR评分和MetS组分进行校正后，两组间观察到的脂联素浓度显著差异几乎未受影响。值得注意的是，在NAFLD患者中，脂联素水平降低与肝脂肪变性、坏死性炎症和纤维化程度密切相关（所有P值均<0.001）。通过逻辑回归分析，在校正年龄、性别、BMI、HOMA-IR和MetS组分后，低脂联素水平独立预测肝脂肪变性[比值比（OR）2.3，95%置信区间（CI）1.5 - 5.8，P<0.001]和坏死性炎症（OR 3.1，95%CI 1.9 - 7，P<0.001），但不能预测纤维化（P = 0.07）。
NAFLD患者的血浆脂联素浓度明显低于对照组。低脂联素水平与肝脏组织学严重程度密切相关，从而进一步支持脂联素可能参与NAFLD发生发展的假说。
