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肝硬化患者血浆抵抗素浓度升高。

Elevated plasma resistin concentrations in patients with liver cirrhosis.

作者信息

Kakizaki Satoru, Sohara Naondo, Yamazaki Yuichi, Horiguchi Norio, Kanda Daisuke, Kabeya Kenji, Katakai Kenji, Sato Ken, Takagi Hitoshi, Mori Masatomo

机构信息

Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

出版信息

J Gastroenterol Hepatol. 2008 Jan;23(1):73-7. doi: 10.1111/j.1440-1746.2006.04757.x.

Abstract

BACKGROUND

Resistin, an adipose-derived polypeptide hormone, has been proposed to be a candidate in insulin resistance, although its role in humans remains controversial. Liver cirrhosis (LC) is characterized by an elevated number of circulating proinflammatory cytokines, hyperinsulinemia and insulin resistance. The aim of this study was to determine the plasma resistin levels in patients with LC.

METHODS

Resistin levels were determined in 79 patients with LC and in 31 healthy controls. Patients included 34 with Child-Pugh grade A, 30 with Child's B and 15 with Child's C LC. Fasting plasma glucose, fasting plasma insulin, adiponectin, the homeostatic model assessment insulin resistance (HOMA-IR) index, quantitative insulin sensitivity check index (QUICKI) and biochemical parameters were also determined.

RESULTS

Plasma resistin levels were 7.61 +/- 6.70 ng/mL in the LC patients and 3.38 +/- 1.68 ng/mL in the controls, respectively. The plasma resistin levels were significantly elevated in patients with LC in comparison to the controls (P < 0.01). The plasma resistin levels increased in a stepwise fashion in line with a higher grade according to Child-Pugh classification. Fasting plasma insulin, adiponectin and HOMA-IR index were also significantly elevated in patients with LC in comparison to controls. Inversely, QUICKI significantly decreased in patients with LC. According to Spearman's rank correlation, log resistin showed significantly positive correlation with fasting plasma insulin, log adiponectin, HOMA-IR index, and a negative correlation with QUICKI (P < 0.01). The plasma resistin levels did not correlate with sex, body mass index and fasting plasma glucose levels.

CONCLUSION

The plasma resistin levels increased in patients with LC, thus showing a positive correlation with fasting plasma insulin, adiponectin, HOMA-IR index, and a negative correlation with QUICKI. Although a decreased extraction of resistin due to reduced liver function cannot be ruled out, resistin may contribute to insulin resistance in patients with LC. The pathophysiological roles of resistin in LC still require further investigation.

摘要

背景

抵抗素是一种脂肪源性多肽激素,尽管其在人类中的作用仍存在争议,但已被认为是胰岛素抵抗的一个候选因素。肝硬化(LC)的特征是循环促炎细胞因子数量增加、高胰岛素血症和胰岛素抵抗。本研究的目的是测定LC患者的血浆抵抗素水平。

方法

测定了79例LC患者和31例健康对照者的抵抗素水平。患者包括34例Child-Pugh A级、30例Child B级和15例Child C级LC患者。还测定了空腹血糖、空腹血浆胰岛素、脂联素、稳态模型评估胰岛素抵抗(HOMA-IR)指数、定量胰岛素敏感性检查指数(QUICKI)和生化参数。

结果

LC患者的血浆抵抗素水平分别为7.61±6.70 ng/mL,对照组为3.38±1.68 ng/mL。与对照组相比,LC患者的血浆抵抗素水平显著升高(P<0.01)。根据Child-Pugh分类,血浆抵抗素水平随着分级升高而呈逐步上升趋势。与对照组相比,LC患者的空腹血浆胰岛素、脂联素和HOMA-IR指数也显著升高。相反,LC患者的QUICKI显著降低。根据Spearman等级相关性分析,log抵抗素与空腹血浆胰岛素、log脂联素、HOMA-IR指数呈显著正相关,与QUICKI呈负相关(P<0.01)。血浆抵抗素水平与性别、体重指数和空腹血糖水平无关。

结论

LC患者的血浆抵抗素水平升高,因此与空腹血浆胰岛素、脂联素、HOMA-IR指数呈正相关,与QUICKI呈负相关。尽管不能排除由于肝功能降低导致抵抗素提取减少,但抵抗素可能在LC患者的胰岛素抵抗中起作用。抵抗素在LC中的病理生理作用仍需进一步研究。

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