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内脂素对非酒精性脂肪性肝病组织病理学变化的影响。

Influence of visfatin on histopathological changes of non-alcoholic fatty liver disease.

作者信息

Aller R, de Luis D A, Izaola O, Sagrado M Gonzalez, Conde R, Velasco M C, Alvarez T, Pacheco D, González J M

机构信息

Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Rio Hortega, University of Valladolid, C/Los perales 16, 47130, Simancas, Valladolid, Spain.

出版信息

Dig Dis Sci. 2009 Aug;54(8):1772-7. doi: 10.1007/s10620-008-0539-9. Epub 2008 Nov 14.

Abstract

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is a common liver disease. The aim of the present study was to explore the relation of visfatin with underlying histopathological changes of NAFLD patients.

SUBJECTS

A population of 55 NAFLD patients was analyzed in a cross-sectional study. A liver biopsy was realized. Weight, basal glucose, insulin, insulin resistance (HOMA), total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and visfatin levels were measured. A bioimpedance was performed.

RESULTS AND CONCLUSIONS

The mean age was 42.8 +/- 11.2 years, the mean BMI was 33.1 +/- 10.2 with 37 males (67.3%) and 18 females (32.7%). Probabilities to have; portal inflammation increased 1.11 (CI95%:1.03-1.50) with each increment of 1 ng/ml of visfatin concentration, high grade of steatosis increased 1.25 (CI 95%:1.06-1.61) with each unit of insulin concentrations, fibrosis increased 1.12 (CI 95%:1.02-1.43) with each unit of fat mass and lobulillar inflammation increased 13.4 (CI 95%:1.3-147) with each unit of HOMA-IR. Portal inflammation frequencies were different between groups (low visfatin group 13.07 < ng/ml: 37.5% versus high visfatin group 13.07 > ng/ml: 62.5%; P < 0.05). In conclusion, several histopathological changes in liver biopsies could be explained by insulin concentrations, HOMA-IR, and fat mass amount. Moreover, visfatin plasma concentrations could predict the presence of portal inflammation in NAFLD patients.

摘要

背景

非酒精性脂肪性肝病(NAFLD)是一种常见的肝脏疾病。本研究的目的是探讨内脂素与NAFLD患者潜在组织病理学变化之间的关系。

研究对象

在一项横断面研究中分析了55例NAFLD患者。进行了肝活检。测量了体重、基础血糖、胰岛素、胰岛素抵抗(HOMA)、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯和内脂素水平。进行了生物电阻抗分析。

结果与结论

平均年龄为42.8±11.2岁,平均BMI为33.1±10.2,其中男性37例(67.3%),女性18例(32.7%)。内脂素浓度每增加1 ng/ml,门静脉炎症的发生概率增加1.11(95%置信区间:1.03 - 1.50);胰岛素浓度每增加一个单位,重度脂肪变性的发生概率增加1.25(95%置信区间:1.06 - 1.61);脂肪量每增加一个单位,纤维化的发生概率增加1.12(95%置信区间:1.02 - 1.43);HOMA-IR每增加一个单位,小叶炎症的发生概率增加13.4(95%置信区间:1.3 - 147)。不同组之间门静脉炎症频率不同(内脂素水平低组<13.07 ng/ml:37.5%,内脂素水平高组>13.07 ng/ml:62.5%;P<0.05)。总之,肝活检中的几种组织病理学变化可以用胰岛素浓度、HOMA-IR和脂肪量来解释。此外,血浆内脂素浓度可以预测NAFLD患者门静脉炎症的存在。

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