Dullaart Robin P F, de Vries Rindert, Dallinga-Thie Geesje M, Sluiter Wim J, van Tol Arie
Department of Endocrinology, University of Groningen and University Medical Centre Groningen, Groningen, The Netherlands.
Clin Endocrinol (Oxf). 2008 Mar;68(3):375-81. doi: 10.1111/j.1365-2265.2007.03049.x. Epub 2007 Sep 18.
The extent to which plasma phospholipid transfer protein (PLTP) activity is affected by type 2 diabetes mellitus (DM) and metabolic syndrome (MetS) is still unknown. PLTP is synthesized in the liver, and elevated serum transaminases are considered to predict nonalcoholic fatty liver disease (NAFLD). In this study, we examined the relationship between plasma PLTP activity and liver enzymes in subjects with and without DM and MetS.
Plasma PLTP activity, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured in 71 subjects without DM or MetS, 21 without DM but with MetS, 26 with DM but without MetS and 55 with DM and MetS (WHO and NCEP-ATP III criteria).
After controlling for age, sex and alcohol intake, PLTP activity was positively related to both MetS (P < 0.001) and DM (P = 0.001). Serum ALT (P = 0.006) and AST (P = 0.04) were both associated with MetS, but only ALT was associated with DM (P < 0.001). In multiple linear regression models, serum ALT and AST were positively and independently associated with PLTP activity (P < 0.01 for all), even when the presence of MetS and DM was taken into account, as well as after controlling for glycated haemoglobin (HbA(1c)), insulin resistance, triglycerides, free fatty acids (FFA), C-reactive protein (CRP), leptin and adiponectin.
Plasma PLTP activity is determined by MetS and by diabetes per se. Serum transaminases are independently associated with PLTP activity. We suggest that this lipid transfer protein may be a marker for NAFLD.
血浆磷脂转运蛋白(PLTP)活性受2型糖尿病(DM)和代谢综合征(MetS)影响的程度尚不清楚。PLTP在肝脏中合成,血清转氨酶升高被认为可预测非酒精性脂肪性肝病(NAFLD)。在本研究中,我们检测了有无DM和MetS的受试者血浆PLTP活性与肝酶之间的关系。
对71例无DM或MetS、21例无DM但有MetS、26例有DM但无MetS以及55例有DM和MetS(符合WHO和NCEP-ATP III标准)的受试者测定血浆PLTP活性、血清丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)。
在控制年龄、性别和酒精摄入量后,PLTP活性与MetS(P < 0.001)和DM(P = 0.001)均呈正相关。血清ALT(P = 0.006)和AST(P = 0.04)均与MetS相关,但只有ALT与DM相关(P < 0.001)。在多元线性回归模型中,血清ALT和AST与PLTP活性呈正相关且独立相关(均P < 0.01),即使考虑了MetS和DM的存在,以及在控制糖化血红蛋白(HbA1c)、胰岛素抵抗、甘油三酯、游离脂肪酸(FFA)、C反应蛋白(CRP)、瘦素和脂联素之后也是如此。
血浆PLTP活性由MetS和糖尿病本身决定。血清转氨酶与PLTP活性独立相关。我们认为这种脂质转运蛋白可能是NAFLD的一个标志物。