Kukla Michal, Zwirska-Korczala Krystyna, Hartleb Marek, Waluga Marek, Chwist Alina, Kajor Maciej, Ciupinska-Kajor Monika, Berdowska Agnieszka, Wozniak-Grygiel Elzbieta, Buldak Rafal
Department of Physiology, Medical University of Silesia, Zabrze, Poland.
Scand J Gastroenterol. 2010;45(2):235-42. doi: 10.3109/00365520903443852.
Chemerin and vaspin are new adipokines which may modulate inflammatory response and insulin sensitivity in non-alcoholic fatty liver disease (NAFLD). The aims of this study were to assess: (1) circulating levels of chemerin and vaspin and their association with liver histology and markers of liver injury in NAFLD patients; and (2) the relationship between the analyzed adipokines and insulin resistance.
A total of 41 NAFLD patients with body mass index (BMI) 30.4 +/- 3.3 kg/m(2) [20 with non-alcoholic steatohepatitis (NASH) and BMI 30.3 +/- 3.3 kg/m(2) and 21 with simple steatosis/uncertain NASH (SS/UN) and BMI 30.5 +/- 3.4 kg/m(2)] and 10 healthy volunteers with BMI 24.0 +/- 2.9 kg/m(2) were included in the study.
Serum chemerin concentration was significantly higher in NAFLD patients compared to healthy volunteers (p = 0.009). Serum chemerin was significantly higher in patients with NASH compared to patients with SS/UN (p = 0.009). The homeostasis model assessment for insulin resistance (HOMA-IR) value was higher in patients with NASH than in patients with SS/UN (p = 0.01). Serum chemerin and HOMA-IR were positively associated with NAFLD activity score (r = 0.40, p = 0.02; and r = 0.43, p = 0.008, respectively). Serum chemerin was associated with hepatocyte ballooning degeneration (r = 0.37; p = 0.03), total cholesterol (r = 0.45; p = 0.008) and diastolic blood pressure (r = 0.41; p = 0.02). HOMA-IR was related to fibrosis stage (r = 0.51; p = 0.001) and inflammatory activity grade in portal tracts (r = 0.40; p = 0.01). Serum vaspin correlated with hepatocyte ballooning degeneration (r = 0.31; p = 0.04), alanine aminotransferase and aspartate aminotransferase (r = 0.33, p = 0.03; and r = 0.32, p = 0.04, respectively) and diastolic blood pressure (r = 0.39, p = 0.01).
This study shows for the first time that chemerin and vaspin serum concentrations are altered in patients with NAFLD. The analyzed adipokines appear to play a pivotal role in the pathogenesis of NAFLD, not only as regulators of insulin sensitivity, but also as mediators of the inflammatory process.
chemerin和vaspin是新型脂肪因子，可能调节非酒精性脂肪性肝病（NAFLD）中的炎症反应和胰岛素敏感性。本研究的目的是评估：（1）NAFLD患者中chemerin和vaspin的循环水平及其与肝脏组织学和肝损伤标志物的关联；（2）所分析的脂肪因子与胰岛素抵抗之间的关系。
本研究纳入了41例体重指数（BMI）为30.4±3.3kg/m²的NAFLD患者[20例非酒精性脂肪性肝炎（NASH）患者，BMI为30.3±3.3kg/m²，21例单纯性脂肪变性/不确定性NASH（SS/UN）患者，BMI为30.5±3.4kg/m²]以及10例BMI为24.0±2.9kg/m²的健康志愿者。
与健康志愿者相比，NAFLD患者的血清chemerin浓度显著更高（p = 0.009）。与SS/UN患者相比，NASH患者的血清chemerin显著更高（p = 0.009）。NASH患者的胰岛素抵抗稳态模型评估（HOMA-IR）值高于SS/UN患者（p = 0.01）。血清chemerin和HOMA-IR与NAFLD活动评分呈正相关（分别为r = 0.40，p = 0.02；r = 0.43，p = 0.008）。血清chemerin与肝细胞气球样变性（r = 0.37；p = 0.03）、总胆固醇（r = 0.45；p = 0.008）和舒张压（r = 0.41；p = 0.02）相关。HOMA-IR与纤维化分期（r = 0.51；p = 0.001）和汇管区炎症活动分级（r = 0.40；p = 0.01）相关。血清vaspin与肝细胞气球样变性（r = 0.31；p = 0.04）、丙氨酸氨基转移酶和天冬氨酸氨基转移酶（分别为r = 0.33，p = 0.03；r = 0.32，p = 0.04）以及舒张压（r = 0.39，p = 0.01）相关。
本研究首次表明NAFLD患者的chemerin和vaspin血清浓度发生改变。所分析的脂肪因子似乎在NAFLD的发病机制中起关键作用，不仅作为胰岛素敏感性的调节因子，还作为炎症过程的介质。
