Huang Xiao-Dong, Fan Yan, Zhang Hen, Wang Ping, Yuan Jing-Ping, Li Ming-Jie, Zhan Xi-Yan
Department of Gastroenterology, The Central Hospital of Wuhan, Wuhan 430014, Hubei Province, China.
World J Gastroenterol. 2008 May 14;14(18):2888-93. doi: 10.3748/wjg.14.2888.
To determine the role of leptin system in non-alcoholic fatty liver disease (NAFLD) development by delineating the changes in serum levels of leptin and soluble leptin receptor (sOB-R).
Blood samples were collected from 30 consecutive patients with liver-biopsy-proven NAFLD and 30 patients with cholecystolithiasis (stationary phase) as controls. Serum leptin levels were determined by radioimmunoassay and concentration of sOB-R was measured by ELISA. Body mass index (BMI) was calculated for all subjects, and serum insulin, C-peptide, and lipoprotein levels were also detected.
Mean serum leptin level and BMI in the NAFLD group were significantly higher than in the controls (both P < 0.001), but mean sOB-R level was lower in the NAFLD group when compared to the controls. Both men and women in the NAFLD group had higher mean serum leptin levels and lower sOB-R levels than did the men and women in the control group (all P < 0.001). There was a significant negative correlation between serum leptin and sOB-R levels (r = -0.725, P < 0.001). Multivariate analysis showed that the percentage of hepatocyte steatosis, sex, BMI, and homeostasis model assessment of insulin resistance (HOMA IR) were independently related to serum leptin levels.
Elevated serum leptin seems to be a feature of steatosis, and serum leptin seems to increase as hepatocyte steatosis develops. An enhanced release of leptin is accompanied by an decrease in sOB-R concentration, which suggests higher resistance of peripheral tissues towards the action of leptin.
通过描绘瘦素和可溶性瘦素受体(sOB-R)血清水平的变化,确定瘦素系统在非酒精性脂肪性肝病(NAFLD)发展中的作用。
连续收集30例经肝活检证实为NAFLD的患者以及30例处于静止期的胆囊结石患者作为对照。采用放射免疫分析法测定血清瘦素水平,用酶联免疫吸附测定法检测sOB-R浓度。计算所有受试者的体重指数(BMI),并检测血清胰岛素、C肽和脂蛋白水平。
NAFLD组的平均血清瘦素水平和BMI显著高于对照组(均P<0.001),但NAFLD组的平均sOB-R水平低于对照组。NAFLD组的男性和女性血清瘦素平均水平均高于对照组的男性和女性,而sOB-R水平则低于对照组(均P<0.001)。血清瘦素与sOB-R水平之间存在显著负相关(r = -0.725,P<0.001)。多变量分析显示,肝细胞脂肪变性百分比、性别、BMI和胰岛素抵抗稳态模型评估(HOMA-IR)与血清瘦素水平独立相关。
血清瘦素升高似乎是脂肪变性的一个特征,并且随着肝细胞脂肪变性的发展血清瘦素似乎会增加。瘦素释放增加的同时sOB-R浓度降低,这表明外周组织对瘦素作用的抵抗性增强。