Centre de Recherche, INSERM Unité 866, Université de Bourgogne, CHU du Bocage, Dijon, France.
Liver Int. 2011 Oct;31(9):1332-6. doi: 10.1111/j.1478-3231.2011.02566.x. Epub 2011 Jun 22.
Recently, it has been shown that an allele in the adiponutrin (PNPLA3) gene was strongly associated with increased liver fat content (LFC) and liver fibrosis independent of visceral adiposity and insulin resistance.
In this study, we set out to determine whether the PNPLA3 rs738409 polymorphism was associated with liver fibrosis in unselected patients with type 2 diabetes.
DESIGN, SETTING AND PARTICIPANTS: Two hundred and thirty-four patients with type 2 diabetes were included in this study.
LFC was evaluated using (1) H-MR spectroscopy; fibrosis was measured using the non-invasive FibroTest(®).
Advanced liver fibrosis (stage F2 or above) was observed in 10.2% of the patients while 149 (63.6%) patients had steatosis. The prevalence of steatosis and fibrosis was higher in minor G allele carriers than that in C allele homozygote carriers (70.3 vs 57.1%; P=0.04 and 14.7 vs 7.5%; P=0.07 respectively). In multivariate analysis, the predictive variables for advanced liver fibrosis were age (≥60) (P=0.005), sex (female) (P=0.004) and rs 738409 PNPLA3 polymorphism (P=0.01); body mass index (BMI) and LFC were not associated with liver fibrosis.
This study confirms that in patients with type 2 diabetes who were not selected for liver abnormalities, liver fibrosis was related to the rs738409 polymorphism independent of BMI or LFC.
最近有研究表明，载脂蛋白 PNPLA3 基因的一个等位基因与肝内脂肪含量（LFC）增加以及与内脏肥胖和胰岛素抵抗无关的肝纤维化密切相关。
本研究旨在确定载脂蛋白 PNPLA3 rs738409 多态性与未经选择的 2 型糖尿病患者的肝纤维化是否相关。
设计、地点和参与者：本研究纳入了 234 例 2 型糖尿病患者。
使用（1）H-MR 光谱法评估 LFC；使用非侵入性 FibroTest（®）测量纤维化。
10.2%的患者存在晚期肝纤维化（F2 期或以上），而 149 例（63.6%）患者存在脂肪变性。在携带 minor G 等位基因的患者中，脂肪变性和纤维化的发生率高于 C 等位基因纯合子携带者（70.3%比 57.1%；P=0.04 和 14.7%比 7.5%；P=0.07）。多变量分析显示，晚期肝纤维化的预测变量为年龄（≥60）（P=0.005）、性别（女性）（P=0.004）和 rs738409 PNPLA3 多态性（P=0.01）；体重指数（BMI）和 LFC 与肝纤维化无关。
本研究证实，在未选择肝脏异常的 2 型糖尿病患者中，肝纤维化与 rs738409 多态性有关，与 BMI 或 LFC 无关。
