Diabetes and Metabolic Disease Research Center, Hidaka Hospital, Takasaki, Japan.
Ann Clin Biochem. 2014 Jan;51(Pt 1):68-79. doi: 10.1177/0004563213487892. Epub 2013 Jul 29.
The association of plasma cardiovascular risk markers and metabolic syndrome (MetS) with non-alcoholic fatty liver disease (NAFLD) has not been well defined.
Japanese men (n = 809) had standard anthropometric measurements done, and had their liver fat quantitated by ultrasound. Three groups were identified: (1) normal controls without significant disease, (2) preliminary-metabolic syndrome (pre-MetS) cases and (3) MetS cases. Plasma adiponectin, high sensitivity-C reactive protein (hs-CRP), HOMA-IR, lipids, lipoproteins and liver enzymes were evaluated among the three groups.
The prevalence of fatty liver was 13% in controls, 39% in pre-MetS and 62% in MetS. Plasma adiponectin and high density lipoprotein cholesterol (HDL-C) were significantly decreased, and HOMA-IR, hs-CRP, TG, remnant lipoproteins (RLPs) and small dense-LDL-C (sd LDL-C) were significantly increased in subjects with fatty liver compared to those without fatty liver. Multivariate analyses of serum parameters associated with fatty liver revealed that adiponectin and hs-CRP were more strongly associated with the presence of fatty liver than waist circumference. However, HOMA-IR, HDL-C, TG, RLP-C, RLP-TG and sd LDL-C were more strongly associated with waist circumference than with fatty liver. Factor analysis revealed that adiponectin and HDL-C were linked to liver enzymes, lipoproteins and HOMA-IR associated with fatty liver, but not with waist circumference.
Adiponectin was found to be a more specific diagnostic marker for the presence of fatty liver regardless of MetS status, and was inversely correlated with liver enzyme concentrations. However, RLPs were found to be more specifically associated with the presence of MetS.
血浆心血管风险标志物与代谢综合征（MetS）与非酒精性脂肪性肝病（NAFLD）的关系尚未明确。
对日本男性（n=809）进行标准人体测量，并通过超声对其肝脏脂肪进行定量。将他们分为三组：（1）无明显疾病的正常对照组；（2）初步代谢综合征（pre-MetS）组；（3）MetS 组。评估三组的血浆脂联素、高敏 C 反应蛋白（hs-CRP）、HOMA-IR、血脂、脂蛋白和肝酶。
正常对照组、pre-MetS 组和 MetS 组的脂肪肝患病率分别为 13%、39%和 62%。与无脂肪肝者相比，脂肪肝患者的血浆脂联素和高密度脂蛋白胆固醇（HDL-C）明显降低，HOMA-IR、hs-CRP、甘油三酯（TG）、残粒脂蛋白（RLP）和小而密 LDL-C（sd LDL-C）明显升高。与腰围相比，血清参数与脂肪肝相关的多元分析显示，脂联素和 hs-CRP 与脂肪肝的关系更为密切。然而，HOMA-IR、HDL-C、TG、RLP-C、RLP-TG 和 sd LDL-C 与腰围的关系比与脂肪肝的关系更为密切。因子分析显示，脂联素和 HDL-C 与肝脏酶、脂蛋白和与脂肪肝相关的 HOMA-IR 有关，但与腰围无关。
无论 MetS 状态如何，脂联素被发现是脂肪肝存在的更特异的诊断标志物，与肝酶浓度呈负相关。然而，RLP 与 MetS 的存在更具特异性相关。
