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大麻素受体基因(CNR1)G1359A多态性对非酒精性脂肪性肝病患者胰岛素抵抗和脂肪因子的影响。

Influence of G1359A polimorphysm of the cannabinoid receptor gene (CNR1) on insulin resistance and adipokines in patients with non alcoholic fatty liver disease.

作者信息

Aller R, de Luis D A, Pacheco D, Velasco M C, Conde R, Izaola O, González Sagrado M

机构信息

Gastroenterology Department, Hospital Clínico Universitario of Valladolid, Valladolid, España.

出版信息

Nutr Hosp. 2012 Sep-Oct;27(5):1637-42. doi: 10.3305/nh.2012.27.5.6011.

Abstract

BACKGROUND

Considering the evidence that endogenous cannabinoid system plays a role in metabolic aspects of body weight and metabolic syndrome components such as non alcoholic fatty liver disease (NAFLD). The aim of our study was to investigate the influence of this polymorphism on insulin resistance, liver histological changes, anthropometric parameters and adipocytokines in patients with NAFLD.

MATERIAL AND METHODS

A population of 71 patients with NAFLD was recruited in a cross sectional study. A biochemical analysis of serum was measured. Genotype of G1359A polymorphism of CB1 receptor gene CB1 receptor was studied. Forty one patients (36.9%) had the genotype G1359G (wild type group) and twenty nine (26.1%) patients G1359A or A1359A (mutant type group).

RESULTS

Twenty four 24 patients (32,3%) had a Brunt grade > 4 and 12 patients (17%) had a significative fibrosis (F > = 2). HOMA values were higher in wild type group than mutant type group. Adiponectin and visfatin levels were higher in mutant type group. Moreover, TNF-alpha and resistin levels were higher in wild type group than mutant type group. Patients with mutant genotype showed less frequently elevated levels of AST. AST > 40 UI/L was detected in 28.5% of patients in the mutant vs. 53% of patients with wild genotype, p < 0.05. Patients with mutant type group presented a percentage of Brunt grade > = 4 less frequently than patients with wild type group (28.5%vs 7.1%).

CONCLUSION

A variant of the polymorphism G1359A CBR1 is associated with lower levels of HOMA, TNF-alpha, resistin and higher levels of adiponectin than patients with the wild variant of this polymorphism. Besides, patients with A allele variant shown lower Brunt grade in liver biopsy.

摘要

背景

鉴于有证据表明内源性大麻素系统在体重的代谢方面以及代谢综合征组分(如非酒精性脂肪性肝病,NAFLD)中发挥作用。我们研究的目的是调查这种多态性对NAFLD患者胰岛素抵抗、肝脏组织学变化、人体测量参数和脂肪细胞因子的影响。

材料与方法

在一项横断面研究中招募了71例NAFLD患者。对血清进行生化分析。研究了CB1受体基因CB1受体G1359A多态性的基因型。41例患者(36.9%)具有基因型G1359G(野生型组),29例患者(26.1%)具有G1359A或A1359A(突变型组)。

结果

24例患者(32.3%)Brunt分级>4,12例患者(17%)有显著纤维化(F>=2)。野生型组的HOMA值高于突变型组。突变型组脂联素和内脂素水平较高。此外,野生型组的TNF-α和抵抗素水平高于突变型组。突变基因型患者AST水平升高的频率较低。突变型患者中28.5%检测到AST>40 UI/L,野生基因型患者中这一比例为53%,p<0.05。突变型组患者Brunt分级>=4的比例低于野生型组患者(28.5%对7.1%)。

结论

与该多态性野生型患者相比,多态性G1359A CBR1的变体与较低的HOMA、TNF-α、抵抗素水平以及较高的脂联素水平相关。此外,具有A等位基因变体的患者在肝脏活检中显示出较低的Brunt分级。

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