Samy Waleed, Hassanian Mohammed A
Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Arab J Gastroenterol. 2011 Jun;12(2):80-5. doi: 10.1016/j.ajg.2011.04.008. Epub 2011 May 18.
The prevalence of non-alcoholic fatty liver disease (NAFLD) appears to be increasing. The aim of the present study was to investigate the relationship between hepatic antioxidant paraoxonase 1 (PON1) activity, lipid peroxidation and antioxidant enzymes in patients with NAFLD and the effect of atorvastatin.
This study was conducted on 50 patients with NAFLD and 20 normal subjects matched for age and sex. All of them were subjected to the following investigations: abdominal ultrasonography, serum PON1 activity level, liver function tests, serum lipid profile, fasting and postprandial blood glucose and serum levels of malondialdehyde (MDA) and glutathione peroxidase (GP). NAFLD patients were further randomly classified into two groups (25 patients each), groups Ia and Ib. Only group Ia received atorvastatin 40mg tablet for 8months.
Obesity, dyslipidaemia and impaired glucose tolerance were prevalent in group I. There was a significant decrease in serum PON1 activity with a significant increase in MDA and GP activity (i.e., there is a significant increase in lipid peroxidation rate) in group I compared with group II. After atorvastatin therapy, there was a significant increase in serum PNO1 activity and significant decrease in serum MDA levels.
Patients with NAFLD show enhanced oxidative stress which may lead to non-alcoholic steatohepatitis (NASH). Reduced PON1 activity and increased MDA could be considered a biochemical marker for lipid peroxidation, which require follow-up in patients with NAFLD. Atorvastatin may have a role in prevention of, or delay, the transformation of liver steatosis into NASH.
非酒精性脂肪性肝病(NAFLD)的患病率似乎在上升。本研究的目的是调查NAFLD患者肝脏抗氧化对氧磷酶1(PON1)活性、脂质过氧化和抗氧化酶之间的关系以及阿托伐他汀的作用。
本研究对50例NAFLD患者和20例年龄及性别匹配的正常受试者进行。所有受试者均接受以下检查:腹部超声检查、血清PON1活性水平、肝功能检查、血脂谱、空腹和餐后血糖以及丙二醛(MDA)和谷胱甘肽过氧化物酶(GP)的血清水平。NAFLD患者进一步随机分为两组(每组25例),即Ia组和Ib组。仅Ia组接受40mg阿托伐他汀片治疗8个月。
I组中肥胖、血脂异常和糖耐量受损很常见。与II组相比,I组血清PON1活性显著降低,MDA和GP活性显著升高(即脂质过氧化率显著升高)。阿托伐他汀治疗后,血清PNO1活性显著升高,血清MDA水平显著降低。
NAFLD患者表现出氧化应激增强,这可能导致非酒精性脂肪性肝炎(NASH)。PON1活性降低和MDA升高可被视为脂质过氧化的生化标志物,NAFLD患者需要对此进行随访。阿托伐他汀可能在预防或延缓肝脏脂肪变性转变为NASH方面发挥作用。