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脂肪因子、炎症介质和胰岛素抵抗参数可能并非肝移植术后代谢综合征的良好标志物。

Adipokines, inflammatory mediators, and insulin-resistance parameters may not be good markers of metabolic syndrome after liver transplant.

作者信息

Anastácio Lucilene Rezende, de Oliveira Marina Chaves, Diniz Kiara Gonçalves, Ferreira Adaliene Matos Versiane, Lima Agnaldo Soares, Correia Maria Isabel Toulson Davisson, Vilela Eduardo Garcia

机构信息

Nutrition Department, Universidade Federal do Triângulo Mineiro, Minas Gerais, Brazil.

Nutrition Department, Nurse School, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.

出版信息

Nutrition. 2016 Sep;32(9):921-7. doi: 10.1016/j.nut.2015.12.038. Epub 2015 Dec 31.

Abstract

OBJECTIVE

The role of adipokines in liver transplantation (LTx) recipients who have metabolic syndrome (MetS) has seldom been assessed. The aim of this study was to investigate the concentrations of adipokines, inflammatory mediators, and insulin-resistance markers in liver recipients with MetS and its components.

METHODS

Serum samples from 34 patients (55.9% male; 54.9 ± 13.9 y; 7.7 ± 2.9 y after LTx; 50% presented with MetS) were assessed for adiponectin, resistin, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, interleukin (IL)-6, C-reactive protein (CRP), homeostatic model assessment-insulin resistance (HOMA-IR) and free fatty acid (FFA) levels. The dosages were uni- and multivariate analyzed to cover MetS (using the Harmonizing MetS criteria), its components, and dietary intake.

RESULTS

A higher concentration of adiponectin (P < 0.05) was observed among patients with MetS (5.2 ± 3.2 μg/mL) compared with those without MetS (3.2 ± 1.2 μg/mL), as well as those with MetS components versus those without them: abdominal obesity (4.6 ± 2.6 μg/mL versus 2.6 ± 0.6 μg/mL), high triacylglycerols (TGs; 5.6 ± 3.1 μg/mL versus 3 ± 0.9 μg/mL) and low high-density lipoprotein (HDL; 6.1 ± 2.7 μg/mL versus 3.3 ± 1.9 μg/mL). Increased TNF-α and HOMA-IR values were seen in patients with abdominal obesity. Patients with high TGs also had greater FFA values. Independent predictors for adiponectin were waist-to-hip ratio, low HDL and high TGs. High TGs and fasting blood glucose were independent predictors for HOMA-IR. Independent predictors could not be identified for CRP, TNF-α, MCP-1, IL-6, or FFA.

CONCLUSIONS

MetS and its components are related to an increased HOMA-IR concentration and FFA. Adiponectin, resistin, and inflammatory markers, such as TNF-α, IL-6, MCP-1, and CRP, were not associated with MetS in this sample of post-LTx patients.

摘要

目的

很少有研究评估脂肪因子在患有代谢综合征(MetS)的肝移植(LTx)受者中的作用。本研究旨在调查患有MetS及其各组分的肝移植受者体内脂肪因子、炎症介质和胰岛素抵抗标志物的浓度。

方法

对34例患者(男性占55.9%;年龄54.9±13.9岁;肝移植后7.7±2.9年;50%患有MetS)的血清样本进行脂联素、抵抗素、肿瘤坏死因子(TNF)-α、单核细胞趋化蛋白(MCP)-1、白细胞介素(IL)-6、C反应蛋白(CRP)、稳态模型评估胰岛素抵抗(HOMA-IR)和游离脂肪酸(FFA)水平的检测。对这些指标进行单因素和多因素分析,以涵盖MetS(采用统一的MetS标准)、其各组分和饮食摄入量。

结果

与未患MetS的患者(3.2±1.2μg/mL)相比,患MetS的患者(5.2±3.2μg/mL)脂联素浓度更高(P<0.05),并且患有MetS各组分的患者与未患这些组分的患者相比也有类似情况:腹型肥胖(4.6±2.6μg/mL对2.6±0.6μg/mL)、高三酰甘油(TGs;5.6±3.1μg/mL对3±0.9μg/mL)和低高密度脂蛋白(HDL;6.1±2.7μg/mL对3.3±1.9μg/mL)。腹型肥胖患者的TNF-α和HOMA-IR值升高。TGs高的患者FFA值也更高。脂联素的独立预测因素是腰臀比、低HDL和高TGs。高TGs和空腹血糖是HOMA-IR的独立预测因素。未发现CRP、TNF-α、MCP-1、IL-6或FFA的独立预测因素。

结论

MetS及其各组分与HOMA-IR浓度升高和FFA有关。在这个肝移植后患者样本中,脂联素、抵抗素以及炎症标志物,如TNF-α、IL-6、MCP-1和CRP,与MetS无关。

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