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非酒精性慢性丙型肝炎病毒感染患者体脂肪与肝内脂肪堆积和细胞因子模式之间的关系。

Relation between body fat and liver fat accumulation and cytokine pattern in non-alcoholic patients with chronic HCV infection.

机构信息

Servicio de Medicina Interna, Hospital Universitario de Canarias, Ofra s/n, La Laguna, Tenerife, Spain.

出版信息

Ann Nutr Metab. 2009;55(4):351-7. doi: 10.1159/000252351. Epub 2009 Oct 23.

Abstract

BACKGROUND

Liver steatosis in chronic hepatitis C virus (HCV) infection is multifactorial. Therefore, there is not necessarily a relation between obesity and liver fat.On the other hand, body fat secretes cytokines, and cytokines and oxidative damage play important roles on progression of liver disease.

METHODS

We analyzed the relationships between liver fat (assessed by histomorphometry) and trunk and subcutaneous fat (waist perimeter, triceps skinfold, BMI); the relationships between liver and body fat and cytokines (IL-6, TNF-alpha, IL-8, IFN-gamma, IL-4), adipokines (adiponectin and TIMP-1), and serum malondiladehyde and antioxidants (glutathione peroxidase and superoxide dismutase (SOD) activities); and the relationships of these data with histological changes in 40 HCV-infected non-alcoholic patients.

RESULTS

Significant correlations were found between liver fat and waist perimeter and BMI, and between serum TIMP-1 and liver fat. Serum TIMP-1 was significantly related to body fat stores; serum IL-6 and IFN-gamma were related to histological inflammation. Patients with waist perimeter >102 cm (men) or 88 cm (women) showed increased liver fat. In 38.8% of non-obese patients, liver fat accumulation was intense.

CONCLUSIONS

There is a relationship between visceral fat, serum TIMP-1 and liver steatosis. However, at least in some patients, factors different from mere adiposity play a role in liver steatosis.

摘要

背景

慢性丙型肝炎病毒 (HCV) 感染患者的肝脂肪变性是多因素的。因此,肥胖与肝脂肪之间不一定存在关系。另一方面,体脂会分泌细胞因子,而细胞因子和氧化损伤在肝病的进展中起着重要作用。

方法

我们分析了肝脂肪(通过组织形态计量学评估)与躯干和皮下脂肪(腰围、肱三头肌皮褶、BMI)之间的关系;肝脂肪与体脂肪以及细胞因子(IL-6、TNF-α、IL-8、IFN-γ、IL-4)、脂肪因子(脂联素和 TIMP-1)以及血清丙二醛和抗氧化剂(谷胱甘肽过氧化物酶和超氧化物歧化酶(SOD)活性)之间的关系;以及这些数据与 40 例非酒精性 HCV 感染患者的组织学变化之间的关系。

结果

肝脂肪与腰围和 BMI 之间存在显著相关性,与血清 TIMP-1 与肝脂肪之间存在显著相关性。血清 TIMP-1 与体脂储存显著相关;血清 IL-6 和 IFN-γ与组织学炎症相关。腰围>102cm(男性)或 88cm(女性)的患者肝脂肪增加。在 38.8%的非肥胖患者中,肝脂肪堆积严重。

结论

内脏脂肪、血清 TIMP-1 与肝脂肪变性之间存在相关性。然而,至少在某些患者中,除了单纯肥胖之外,还有其他因素在肝脂肪变性中起作用。

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