Department of Digestive Tract Diseases, Medical University of Lodz, Poland.
J Physiol Pharmacol. 2009 Oct;60 Suppl 3:71-5.
Nonalcoholic steatohepatitis (NASH) represents one of the most common liver diseases. It is strongly associated with obesity and insulin resistance and is thought to be part of the metabolic syndrome. NASH can progress to cirrhosis and liver failure. Adipohormones, synthesized in adipose tissue, are involved in the pathophysiology of many acute and chronic liver diseases. The aim of this study was to evaluate the plasma concentrations of adiponectin, resistin, leptin, TNF-alpha and Il-6 in patients with NASH, as well as their correlation with the pathologic parameters. Serum concentration of leptin, adiponectin, resistin, insulin, TNF-alpha, IL-6 were measured with ELISA method. Liver biopsies were obtained from 18 (age 42.55+/-21 years) patients. NASH has been classified according to Dixon score. The control group was represented by 16 non-obese subjects. Mean serum concentration of adiponectin in patients with NASH was significantly lower than in healthy subjects (4.87+/-1.96 vs. 8.33+/-4.56 ng/ml; p<0.05). Mean serum levels of TNF-alpha in patients with NASH were significantly higher than in controls (34.2+/-19.7 vs. 20.7+/-15.5 ng/ml; p<0.05). In patients with more advanced inflammation (grade 2-3) and fibrosis (stage 2) in pathology, serum concentration of leptin was significantly higher than in patients with steatosis and less advanced inflammation (grade 1) and fibrosis (stage 1) (median 8.94 vs. 16.2 ng/ml; p<0.05). No significant differences of serum concentration of others adipohormones between these two groups of patients were stated. Moreover, we observed the correlation in serum levels (examined group vs controls) between: resistin and TNF-alpha (r = 0.62; p<0.05), adiponectin and IL-6 (r = -0.60; p<0.05) and leptin and insulin (r = -0.51; p<0.05). In conclusion, based on our study we speculate that changes of adipohormones levels may be markers of NASH and the serum level of leptin can be associated with more advanced form of NASH.
非酒精性脂肪性肝炎（NASH）是最常见的肝脏疾病之一。它与肥胖和胰岛素抵抗密切相关，被认为是代谢综合征的一部分。NASH 可进展为肝硬化和肝功能衰竭。脂肪细胞合成的脂肪激素参与许多急性和慢性肝病的病理生理过程。本研究旨在评估 NASH 患者血浆中脂联素、抵抗素、瘦素、TNF-α和 IL-6 的浓度，并探讨其与病理参数的相关性。采用 ELISA 法测定血清瘦素、脂联素、抵抗素、胰岛素、TNF-α、IL-6 浓度。从 18 名（年龄 42.55+/-21 岁）患者中获得肝活检。根据 Dixon 评分对 NASH 进行分类。对照组由 16 名非肥胖受试者组成。NASH 患者的血清脂联素浓度明显低于健康对照组（4.87+/-1.96 vs. 8.33+/-4.56ng/ml；p<0.05）。NASH 患者的 TNF-α血清水平明显高于对照组（34.2+/-19.7 vs. 20.7+/-15.5ng/ml；p<0.05）。在病理学中炎症程度更严重（2-3 级）和纤维化程度（2 期）的患者中，血清瘦素浓度明显高于脂肪变性且炎症程度较轻（1 级）和纤维化程度较低（1 期）的患者（中位数 8.94 vs. 16.2ng/ml；p<0.05）。两组患者之间的其他脂肪激素血清浓度无显著差异。此外，我们观察到在血清水平（实验组与对照组）之间的相关性：抵抗素与 TNF-α（r = 0.62；p<0.05）、脂联素与 IL-6（r = -0.60；p<0.05）和瘦素与胰岛素（r = -0.51；p<0.05）。总之，根据我们的研究，我们推测脂肪激素水平的变化可能是 NASH 的标志物，而瘦素的血清水平可能与更严重的 NASH 有关。
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