Ercin Cemal Nuri, Dogru Teoman, Genc Halil, Celebi Gurkan, Aslan Fatih, Gurel Hasan, Kara Muammer, Sertoglu Erdim, Tapan Serkan, Bagci Sait, Rizzo Manfredi, Sonmez Alper
1 Gulhane School of Medicine , Department of Gastroenterology, Ankara, Turkey .
2 İzmir Military Hospital 2, İzmir, Turkey .
Metab Syndr Relat Disord. 2015 Sep;13(7):319-25. doi: 10.1089/met.2015.0018. Epub 2015 May 26.
Nonalcoholic fatty liver disease (NAFLD) is associated with obesity, type 2 diabetes mellitus, and dyslipidemia. It is well known that the presence of visceral fat increases the risk for metabolic complications of obesity, especially NAFLD. The visceral adiposity index (VAI), a novel marker of visceral fat dysfunction, shows a strong association with insulin resistance and also cardiovascular and cerebrovascular events. However, there is conflicting data regarding the association between VAI and NAFLD. Our aim was to assess the relationship between VAI, insulin resistance, adipocytokines, and liver histology, in nondiabetic subjects with NAFLD.
A total of 215 male patients with biopsy-proven NAFLD were included. Among this group, serum levels of adiponectin, tumor necrosis factor-α (TNF-α, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hsCRP) were measured in 101 patients whose blood samples were available.
High gamma-glutamyl transferase (GGT), high total cholesterol (TC), high triglycerides (TGs), low high-density lipoprotein cholesterol (HDL-C), and presence of metabolic syndrome were significantly associated with higher VAI, although only higher GGT and TC were independent factors on multiple linear regression analysis. On the other hand, no significant association was found between VAI and adiponectin, TNF-α, IL-6, and hsCRP levels. The multivariate analysis of variables in patients with (n=124) and without (n=91) fibrosis showed that only higher homeostasis model assessment of insulin resistance value was independently associated with liver fibrosis.
Our findings suggest that VAI is not related to the severity of hepatic inflammation or fibrosis in nondiabetic patients with NAFLD. The lack of association between the adipocytokines and VAI also implies that the VAI may not be a significant indictor of the adipocyte functions.
非酒精性脂肪性肝病（NAFLD）与肥胖、2型糖尿病和血脂异常相关。众所周知，内脏脂肪的存在会增加肥胖代谢并发症的风险，尤其是NAFLD。内脏肥胖指数（VAI）是内脏脂肪功能障碍的一种新型标志物，与胰岛素抵抗以及心血管和脑血管事件密切相关。然而，关于VAI与NAFLD之间的关联数据存在矛盾。我们的目的是评估非糖尿病NAFLD患者中VAI、胰岛素抵抗、脂肪细胞因子和肝脏组织学之间的关系。
共纳入215例经活检证实为NAFLD的男性患者。在这组患者中，对101例有血样的患者检测了脂联素、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和高敏C反应蛋白（hsCRP）的血清水平。
高γ-谷氨酰转移酶（GGT）、高总胆固醇（TC）、高甘油三酯（TGs）、低高密度脂蛋白胆固醇（HDL-C）以及代谢综合征的存在与较高的VAI显著相关，尽管在多元线性回归分析中只有较高的GGT和TC是独立因素。另一方面，未发现VAI与脂联素、TNF-α、IL-6和hsCRP水平之间存在显著关联。对有（n = 124）和无（n = 91）纤维化患者的变量进行多因素分析显示，只有较高的胰岛素抵抗稳态模型评估值与肝纤维化独立相关。
我们的研究结果表明，VAI与非糖尿病NAFLD患者的肝脏炎症或纤维化严重程度无关。脂肪细胞因子与VAI之间缺乏关联也意味着VAI可能不是脂肪细胞功能的重要指标。
