Gorden Alexis, Yang Rongze, Yerges-Armstrong Laura M, Ryan Kathleen A, Speliotes Elizabeth, Borecki Ingrid B, Harris Tamara B, Chu Xin, Wood G Craig, Still Christopher D, Shuldiner Alan R, Gerhard Glenn S
Division of Gastroenterology, University of Maryland School of Medicine, Baltimore, MD, USA.
Hum Hered. 2013;75(1):34-43. doi: 10.1159/000346195. Epub 2013 Apr 10.
Obesity-associated non-alcoholic fatty liver disease (NAFLD) may cause liver dysfunction and failure. In a previously reported genome-wide association meta-analysis, single nucleotide polymorphisms (SNPs) near PNPLA3, NCAN, GCKR, LYPLAL1 and PPP1R3B were associated with NAFLD and with distinctive serum lipid profiles. The present study examined the relevance of these variants to NAFLD in extreme obesity.
In 1,092 bariatric surgery patients, the candidate SNPs were genotyped and association analyses with liver histology and serum lipids were performed.
We replicated the association of hepatosteatosis with PNPLA3 rs738409[G] and with NCAN rs2228603[T]. We also replicated the association of rs2228603[T] with hepatic inflammation and fibrosis. rs2228603[T] was associated with lower serum low-density lipoprotein, total cholesterol and triglycerides. After stratification by the presence or absence of NAFLD, these associations were present predominantly in the subgroup with NAFLD.
NCAN rs2228603[T] is a risk factor for liver inflammation and fibrosis, suggesting that this locus is responsible for progression from steatosis to steatohepatitis. In this bariatric cohort, rs2228603[T] was associated with low serum lipids only in patients with NAFLD. This supports a NAFLD model in which the liver may sequester triglycerides as a result of either increased triglyceride uptake and/or decreased lipolysis.
肥胖相关的非酒精性脂肪性肝病(NAFLD)可能导致肝功能障碍和衰竭。在先前报道的全基因组关联荟萃分析中,PNPLA3、NCAN、GCKR、LYPLAL1和PPP1R3B附近的单核苷酸多态性(SNP)与NAFLD及独特的血清脂质谱相关。本研究探讨了这些变异与极端肥胖患者NAFLD的相关性。
对1092例接受减肥手术的患者进行候选SNP基因分型,并进行肝脏组织学和血脂的关联分析。
我们重复验证了肝脂肪变性与PNPLA3 rs738409[G]以及与NCAN rs2228603[T]的关联。我们还重复验证了rs2228603[T]与肝脏炎症和纤维化的关联。rs2228603[T]与较低的血清低密度脂蛋白、总胆固醇和甘油三酯相关。按是否存在NAFLD分层后,这些关联主要存在于患有NAFLD的亚组中。
NCAN rs2228603[T]是肝脏炎症和纤维化的危险因素,表明该基因座是导致从脂肪变性进展为脂肪性肝炎的原因。在这个减肥队列中,rs2228603[T]仅在患有NAFLD的患者中与低血脂相关。这支持了一种NAFLD模型,即肝脏可能由于甘油三酯摄取增加和/或脂肪分解减少而蓄积甘油三酯。