非酒精性脂肪性肝病与亚临床炎症密切相关：一项针对印度北部亚裔人群的病例对照研究。
Non-alcoholic fatty liver disease is closely associated with sub-clinical inflammation: a case-control study on Asian Indians in North India.
机构信息
National Diabetes Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India.
出版信息
PLoS One. 2013;8(1):e49286. doi: 10.1371/journal.pone.0049286. Epub 2013 Jan 11.
OBJECTIVES
Association between sub-clinical inflammation and non-alcoholic fatty liver disease (NAFLD) has not been studied in Asian Indians. In this case-control study, we aimed to analyse association of NAFLD with the sub-clinical inflammation and metabolic profile in Asian Indians in north India.
METHODS
Ultrasound diagnosed 120 cases of NAFLD were compared to 152 healthy controls without NAFLD. Anthropometric profile [body mass index (BMI), waist circumference (WC), hip circumference (HC)], high-sensitivity C-reactive protein (hs-CRP), metabolic profile [fasting blood glucose (FBG), lipid profile] and hepatic function tests [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] were recorded.
RESULTS
Metabolic parameters [FBG, total cholesterol (TC), serum triglycerides (TG),low-density lipoprotein (LDL-c)], hs-CRP and prevalence of the metabolic syndrome were higher in cases as compared to controls (p-value<0.05 for all). The median (range) of hs-CRP (mg/L) for cases [2.6(0.2-13.4)] were significantly higher than in controls [1.4(0.03-11.4), p = 0.01]. Similarly, higher values of hs-CRP were obtained when subgroups of cases with obesity, abdominal obesity and the metabolic syndrome were compared to controls [2.75 (0.03-14.3) vs. 1.52 (0.04-14.3), p = 0.0010; 2.8 (0.03-14.3) vs. 1.5 (0.06-14.3), p = 0.0014 and 2.7 (0.5-14.3) vs. 1.6 (0.06-8.5), p = 0.0013, respectively. On multivariate logistic regression analysis BMI (p = 0.001), WC (p = 0.001), FBG (p = 0.002), TC (p = 0.008), TG (p = 0.002), blood pressure (p = 0.005), metabolic syndrome (p = 0.001) and hs-CRP (p = 0.003) were significantly and independently associated with NAFLD. After adjusting for significant variables, the association between high hs-CRP and NAFLD remained large and statistically significant [adjusted OR = 1.17, 95% confidence interval (CI) = 1.05-1.29]. An increase in 1 mg/dl of hs-CRP level calculated to increase the risk of developing NAFLD by 1.7 times as compared to controls after adjusting for significant variables associated with NAFLD.
CONCLUSIONS
In this cohort of Asian Indians in North India, presence of NAFLD showed independent relationships with sub-clinical inflammation.
目的
亚临床炎症与非酒精性脂肪性肝病（NAFLD）之间的关系尚未在亚洲印第安人中进行研究。在这项病例对照研究中，我们旨在分析亚临床炎症与印度北部亚洲印第安人 NAFLD 之间的代谢特征之间的关系。
方法
超声诊断的 120 例 NAFLD 病例与 152 例无 NAFLD 的健康对照进行比较。记录人体测量参数[体重指数（BMI）、腰围（WC）、臀围（HC）]、高敏 C 反应蛋白（hs-CRP）、代谢特征[空腹血糖（FBG）、血脂谱]和肝功能检查[丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）]。
结果
与对照组相比，病例组的代谢参数[FBG、总胆固醇（TC）、血清甘油三酯（TG）、低密度脂蛋白（LDL-c）]、hs-CRP 和代谢综合征的患病率更高（所有 p 值均<0.05）。病例组 hs-CRP（mg/L）的中位数（范围）[2.6（0.2-13.4）]明显高于对照组[1.4（0.03-11.4），p=0.01]。同样，与对照组相比，肥胖、腹部肥胖和代谢综合征亚组的 hs-CRP 值更高[2.75（0.03-14.3）比 1.52（0.04-14.3），p=0.0010；2.8（0.03-14.3）比 1.5（0.06-14.3），p=0.0014；2.7（0.5-14.3）比 1.6（0.06-8.5），p=0.0013]。多变量逻辑回归分析显示 BMI（p=0.001）、WC（p=0.001）、FBG（p=0.002）、TC（p=0.008）、TG（p=0.002）、血压（p=0.005）、代谢综合征（p=0.001）和 hs-CRP（p=0.003）与 NAFLD 显著且独立相关。在调整显著变量后，hs-CRP 水平升高与 NAFLD 之间的关联仍然较大且具有统计学意义[调整后的 OR=1.17，95%置信区间（CI）=1.05-1.29]。与对照组相比，调整与 NAFLD 相关的显著变量后，hs-CRP 水平每增加 1mg/dl，患 NAFLD 的风险增加 1.7 倍。
结论
在印度北部的这组亚洲印第安人中，NAFLD 的存在与亚临床炎症之间存在独立关系。
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