Başar O, Akbal E, Köklü S, Tuna Y, Koçak E, Başar N, Tok D, Erbiş H, Senes M
Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey.
Herz. 2013 Jun;38(4):417-22. doi: 10.1007/s00059-012-3714-x. Epub 2013 Jan 18.
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder which is reported as the hepatic manifestation of metabolic syndrome with an increased risk of cardiovascular events. Patients with NAFLD are also at risk of future cardiac events independently of metabolic syndrome. The aim of this study was to examine serum concentrations of heart type fatty acid binding protein (H-FABP) in NAFLD and to investigate its correlations with metabolic parameters and subclinical atherosclerosis.
A total of 34 patients with NAFLD and 35 healthy subjects were enrolled in the study. NAFLD patients had elevated liver enzymes and steatosis graded on ultrasonography. Healthy subjects had normal liver enzymes and no steatosis on ultrasonography. H-FABP levels were measured using an enzyme linked immunosorbent assay (ELISA) method and correlations with metabolic parameters and subclinical atherosclerosis were examined. Subclinical atherosclerosis was determined with carotid artery intima-media thickness (CIMT) which was measured by high resolution B mode ultrasonography.
H-FABP levels were elevated in patients with NAFLD (16.3 ± 4.0 ng/ml) when compared with healthy controls (13.8 ± 2.1 ng/ml; p < 0.001). NAFLD patients had significantly higher CIMT than the controls had (0.64 ± 0.17 mm vs. 0.43 ± 0.14 mm, p = 0.009). The H-FABP concentrations were significantly positively correlated with body mass index (r = 0.255, p = 0.042), fasting blood glucose level (r = 0.300, p = 0.013), CIMT (r = 0.335, p = 0.043), and homeostasis model assessment-estimated insulin resistance (HOMA-IR; r = 0.156, p = 0.306). In multiple linear regression analysis, H-FABP levels were only independently associated with CIMT (p = 0.04)
Serum H-FABP concentrations increase in patients with NAFLD. Our results may not only suggest that H-FABP is a marker of subclinical myocardial damage in patients with NAFLD but also of subclinical atherosclerosis, independent of metabolic syndrome and cardiac risk factors.
非酒精性脂肪性肝病（NAFLD）是最常见的肝脏疾病，被报道为代谢综合征的肝脏表现，心血管事件风险增加。NAFLD患者未来发生心脏事件的风险也独立于代谢综合征。本研究的目的是检测NAFLD患者血清中心脏型脂肪酸结合蛋白（H-FABP）的浓度，并研究其与代谢参数和亚临床动脉粥样硬化的相关性。
本研究共纳入34例NAFLD患者和35例健康受试者。NAFLD患者肝酶升高，超声检查显示有脂肪变性。健康受试者肝酶正常，超声检查无脂肪变性。采用酶联免疫吸附测定（ELISA）法检测H-FABP水平，并研究其与代谢参数和亚临床动脉粥样硬化的相关性。采用高分辨率B型超声测量颈动脉内膜中层厚度（CIMT）来确定亚临床动脉粥样硬化。
与健康对照组（13.8±2.1 ng/ml）相比，NAFLD患者的H-FABP水平升高（16.3±4.0 ng/ml；p＜0.001）。NAFLD患者的CIMT显著高于对照组（0.64±0.17 mm对0.43±0.14 mm，p = 0.009）。H-FABP浓度与体重指数（r = 0.255，p = 0.042）、空腹血糖水平（r = 0.300，p = 0.013）、CIMT（r = 0.335，p = 0.043）和稳态模型评估估计的胰岛素抵抗（HOMA-IR；r = 0.156，p = 0.306）显著正相关。在多元线性回归分析中，H-FABP水平仅与CIMT独立相关（p = 0.04）
NAFLD患者血清H-FABP浓度升高。我们的结果可能不仅提示H-FABP是NAFLD患者亚临床心肌损伤的标志物，也是亚临床动脉粥样硬化的标志物，独立于代谢综合征和心脏危险因素。
