Puri Puneet, Baillie Rebecca A, Wiest Michelle M, Mirshahi Faridoddin, Choudhury Jayanta, Cheung Onpan, Sargeant Carol, Contos Melissa J, Sanyal Arun J
Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA 23298, USA.
Hepatology. 2007 Oct;46(4):1081-90. doi: 10.1002/hep.21763.
The spectrum of nonalcoholic fatty liver disease (NAFLD) includes a nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). The specific types and amounts of lipids that accumulate in NAFLD are not fully defined. The free fatty acid (FFA), diacylglycerol (DAG), triacylglycerol (TAG), free cholesterol (FC), cholesterol ester, and phospholipid contents in normal livers were quantified and compared to those of NAFL and NASH, and the distribution of fatty acids within these classes was compared across these groups. Hepatic lipids were quantified by capillary gas chromatography. The mean (nmol/g of tissue) DAG (normal/NAFL/NASH: 1922 versus 4947 versus 3304) and TAG (13,609 versus 128,585 versus 104,036) increased significantly in NAFLD, but FFA remained unaltered (5533 versus 5929 versus 6115). There was a stepwise increase in the mean TAG/DAG ratio from normal livers to NAFL to NASH (7 versus 26 versus 31, P < 0.001). There was also a similar stepwise increment in hepatic FC (7539 versus 10,383 versus 12,863, P < 0.05 for NASH). The total phosphatidylcholine (PC) decreased in both NAFL and NASH. The FC/PC ratio increased progressively (0.34 versus 0.69 versus 0.71, P < 0.008 for both). Although the levels for linoleic acid (18:2n-6) and alpha-linolenic acid (18:3n-3) remained unaltered, there was a decrease in arachidonic acid (20:4n-6) in FFA, TAG, and PC (P < 0.05 for all) in NASH. Eicosapentanoic acid (20:5n-3) and docosahexanoic acid (22:6n-3) were decreased in TAG in NASH. The n-6:n-3 FFA ratio increased in NASH (P < 0.05).
NAFLD is associated with numerous changes in the lipid composition of the liver. The potential implications are discussed.
非酒精性脂肪性肝病(NAFLD)的谱系包括非酒精性脂肪肝(NAFL)和非酒精性脂肪性肝炎(NASH)。NAFLD中积累的脂质的具体类型和数量尚未完全明确。对正常肝脏中的游离脂肪酸(FFA)、二酰基甘油(DAG)、三酰基甘油(TAG)、游离胆固醇(FC)、胆固醇酯和磷脂含量进行了定量,并与NAFL和NASH的含量进行比较,同时比较了这些类别中脂肪酸在这些组中的分布情况。通过毛细管气相色谱法定量肝脏脂质。在NAFLD中,平均(每克组织纳摩尔数)DAG(正常/NAFL/NASH:1922对4947对3304)和TAG(13609对128585对104036)显著增加,但FFA保持不变(5533对5929对6115)。从正常肝脏到NAFL再到NASH,平均TAG/DAG比值呈逐步增加(7对26对31,P<0.001)。肝脏FC也有类似的逐步增加(7539对10383对12863,NASH时P<0.05)。在NAFL和NASH中,总磷脂酰胆碱(PC)均降低。FC/PC比值逐渐升高(0.34对0.69对0.71,两者均P<0.008)。尽管亚油酸(18:2n-6)和α-亚麻酸(18:3n-3)水平保持不变,但在NASH中,FFA、TAG和PC中的花生四烯酸(20:4n-6)均降低(所有均P<0.05)。在NASH中,TAG中的二十碳五烯酸(20:5n-3)和二十二碳六烯酸(22:6n-3)降低。NASH中n-6:n-3 FFA比值升高(P<0.05)。
NAFLD与肝脏脂质组成的众多变化相关。讨论了其潜在影响。