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生长激素、胰岛素样生长因子 1 和胰岛素样生长因子结合蛋白 3 在非酒精性脂肪性肝病发病机制中的作用。

Role of growth hormone, insulin-like growth factor 1 and insulin-like growth factor-binding protein 3 in development of non-alcoholic fatty liver disease.

机构信息

The First department of Internal Medicine, Graduate school of Biomedical science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan,

出版信息

Hepatol Int. 2007 Jun;1(2):287-94. doi: 10.1007/s12072-007-9007-4. Epub 2007 Jun 1.

Abstract

BACKGROUND AND AIMS

Pituitary dysfunction including growth hormone (GH) deficiency may be associated with non-alcoholic fatty liver disease (NAFLD). Since the relationships among GH, IGF-1, IGFBP-3, and development of NAFLD without hypopituitarism are unclear, we examined the role of these hormones in the development of NAFLD based on clinical, laboratory and liver histology data.

PATIENTS AND METHODS

A total of 55 consecutive patients (20 males and 35 females) with NAFLD.

RESULTS

Aspartate amino transferase (AST), AST/ALT, platelet count and IGF-1, levels were significantly associated with differences in fibrosis, since these variables differed between stage 0-1 and stage 2-3 NAFLD. In multivariate analysis, platelet count (P = 0.0223, relative risk (RR), 5.899; 95% confidence interval (CI), 1.288-27.017), and IGF-1 (P = 0.0363, RR, 4.568; 95% CI, 1.101-18.945) showed significant associations with stage 2-3 NAFLD. Additionally, hyaluronic acid levels had a negative relationship with IGF-1 and the IGF-1/IGFBP-3 ratio. There was no relationship of fibrosis with GH level, but decreased GH (P = 0.0414, RR, 0.199; 95% CI, 0.042-0.989) was significantly associated with steatosis of stage 2-3. Low GH/IGF-1 and GH/IGFBP-3 ratios were found in advanced steatosis.

CONCLUSION

GH, IGF-1 and IGFBP-3 are associated with hepatic fibrosis and steatosis in NAFLD. Low levels of IGF-1 might be associated with fibrosis while low level of GH with hepatic steatosis.

摘要

背景与目的

包括生长激素(GH)缺乏在内的垂体功能障碍可能与非酒精性脂肪性肝病(NAFLD)有关。由于 GH、IGF-1、IGFBP-3 与无垂体功能减退的 NAFLD 之间的关系尚不清楚,我们根据临床、实验室和肝脏组织学数据来研究这些激素在 NAFLD 发展中的作用。

患者和方法

共纳入 55 例连续的 NAFLD 患者(20 名男性和 35 名女性)。

结果

天冬氨酸氨基转移酶(AST)、AST/ALT、血小板计数和 IGF-1 水平与纤维化程度差异显著相关,因为这些变量在 NAFLD 0-1 期和 2-3 期之间有所不同。在多变量分析中,血小板计数(P = 0.0223,相对风险(RR),5.899;95%置信区间(CI),1.288-27.017)和 IGF-1(P = 0.0363,RR,4.568;95%CI,1.101-18.945)与 2-3 期 NAFLD 显著相关。此外,透明质酸水平与 IGF-1 和 IGF-1/IGFBP-3 比值呈负相关。纤维化与 GH 水平无关系,但 GH 降低(P = 0.0414,RR,0.199;95%CI,0.042-0.989)与 2-3 期肝脂肪变性显著相关。在晚期脂肪变性中发现了低 GH/IGF-1 和 GH/IGFBP-3 比值。

结论

GH、IGF-1 和 IGFBP-3 与 NAFLD 中的肝纤维化和脂肪变性有关。IGF-1 水平低可能与纤维化有关,而 GH 水平低可能与肝脂肪变性有关。

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