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过氧化物酶体增殖物激活受体 γ2 Pro12Ala 多态性与脂肪性肝病。

Pro12Ala polymorphism of the peroxisome proliferator-activated receptor γ2 in patients with fatty liver diseases.

机构信息

Institute for Pathology, University Hospital Cologne, Kerpener Str. 62, 50924 Cologne, Germany.

出版信息

World J Gastroenterol. 2010 Dec 14;16(46):5830-7. doi: 10.3748/wjg.v16.i46.5830.

Abstract

AIM

To test the occurrence of the Pro12Ala mutation of the peroxisome proliferator-activated receptor-γ (PPARγ)2-gene in patients with non-alcoholic fatty liver disease (NAFLD) or alcoholic fatty liver disease (AFLD).

METHODS

DNA from a total of 622 specimens including 259 blood samples of healthy blood donors and 363 histologically categorized liver biopsies of patients with NAFLD (n = 263) and AFLD (n = 100) were analyzed by Real-time polymerase chain reaction using allele-specific probes.

RESULTS

In the NAFLD and the AFLD collective, 3% of the patients showed homozygous occurrence of the Ala12 PPARγ2-allele, differing from only 1.5% cases in the healthy population. In NAFLD patients, a high incidence of the Ala12 mutant was not associated with the progression of fatty liver disease. However, we observed a significantly higher risk (odds ratio = 2.50, CI: 1.05-5.90, P = 0.028) in AFLD patients carrying the mutated Ala12 allele to develop inflammatory alterations. The linkage of the malfunctioning Ala12-positive PPARγ2 isoform to an increased risk in patients with AFLD to develop severe steatohepatitis and fibrosis indicates a more prominent anti-inflammatory impact of PPARγ2 in progression of AFLD than of NAFLD.

CONCLUSION

In AFLD patients, the Pro12Ala single nuclear polymorphism should be studied more extensively in order to serve as a novel candidate in biomarker screening for improved prognosis.

摘要

目的

检测非酒精性脂肪性肝病(NAFLD)或酒精性脂肪性肝病(AFLD)患者过氧化物酶体增殖物激活受体-γ(PPARγ)2 基因 Pro12Ala 突变的发生情况。

方法

采用实时聚合酶链反应,使用等位基因特异性探针,对包括 259 名健康献血者血液样本和 363 例经组织学分类的 NAFLD(n = 263)和 AFLD(n = 100)患者肝活检标本在内的 622 例标本的 DNA 进行分析。

结果

在 NAFLD 和 AFLD 组中,3%的患者表现为 Ala12 PPARγ2-等位基因的纯合发生,与健康人群中仅 1.5%的病例不同。在 NAFLD 患者中,Ala12 突变体的高发生率与脂肪性肝病的进展无关。然而,我们观察到在携带突变型 Ala12 等位基因的 AFLD 患者中,发生炎症改变的风险显著增加(比值比=2.50,95%置信区间:1.05-5.90,P=0.028)。功能失调的 Ala12 阳性 PPARγ2 同工型与 AFLD 患者发生严重脂肪性肝炎和纤维化的风险增加相关,这表明 PPARγ2 在 AFLD 进展中比在 NAFLD 中具有更显著的抗炎作用。

结论

在 AFLD 患者中,应更广泛地研究 Pro12Ala 单核苷酸多态性,以作为改善预后的生物标志物筛选的新候选标志物。

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