Qu Bao-Ge, Bi Weimin, Jia Yi-Guo, Liu Yuan-Xun, Wang Hui, Su Ji-Liang, Liu Li-Li, Wang Zhong-Dong, Wang Ya-Fei, Han Xing-Hai, Pan Jin-Dun, Ren Guang-Ying, Hu Wen-Juan
Department of Gastroenterology, Taishan Hospital, Taian, Shandong, 271000, People's Republic of China.
Surgery of Gastroenterology, Taian City's Central Hospital, Taian, Shandong, 271000, People's Republic of China.
Cell Stress Chaperones. 2016 Sep;21(5):865-72. doi: 10.1007/s12192-016-0711-7. Epub 2016 Jun 21.
The association between alcoholic liver disease (ALD) and the inflammatory response remains controversial. The aim of this study was to explore this association between ALD and inflammation. We enrolled 214 male participants, who were divided into three age-matched groups: ALD (n = 135), chronic alcohol ingestion without ALD (non-ALD; n = 42), and control (n = 37). The BMI was significantly higher in the ALD group than in the non-ALD and control groups (all P = 0.000). Further, the constituent ratio of the liver inflammatory level was significantly higher in the ALD group than in the non-ALD and control groups (P = 0.002 and P = 0.000, respectively). In addition, the median serum ALT, AST, and GGT levels were significantly higher in the ALD group than in the control group (P = 0.023, P = 0.008, and P = 0.000, respectively); these levels were also significantly higher in the ALD group than in the non-ALD group (P = 0.013, P = 0.010, and P = 0.000, respectively). The median serum CRP level was significantly higher in the ALD group than in the non-ALD and control groups (P = 0.006 and P = 0.000, respectively). Further, the median serum TNF-α level was significantly lower in the ALD group than in the non-ALD and control groups (P = 0.004 and P = 0.000, respectively). The median serum sOX40L and HSP70 levels were significantly lower in the ALD group than in the control group (P = 0.008 and P = 0.018, respectively). In addition, the ALT, AST, and GGT levels were positively correlated with the CRP level (r = 0.211, P = 0.002; r = 0.220, P = 0.001 and r = 0.295, P = 0.000, respectively), and the GGT level was negatively correlated with the TNF-α (r = -0.225, P = 0.001), sOX40L (r = -0.165, P = 0.016), and HSP70 levels (r = -0.178, P = 0.009). Further, the Cr level was negatively correlated with the IL-10 level (r = -0.166, P = 0.015). Logistic regression analysis verified that the BMI (OR = 1.637, 95%CI: 1.374-1.951, P = 0.000) and GGT level were significantly higher (OR = 1.039, 95%CI: 1.020-1.059, P = 0.000) and that the TNF-α (OR = 0.998, 95%CI: 0.996-1.000, P = 0.030) and HSP70 levels were significantly lower (OR = 1.017, 95%CI: 1.003-1.031, P = 0.029) in the ALD group than in the non-ALD group. Further, the moderate-to-severe ALD patients had a significantly higher serum CRP level (Or = 1.349, 95%CI: 1.066-1.702, P = 0.013) and significantly lower HSP60 (OR = 0.965, 95%CI: 0.938-0.993, P = 0.014) and HSP70 levels (OR = 0.978, 95%CI: 0.962-0.995, P = 0.010) than the mild ALD patients. These results suggest that ALD patients may present with obesity, liver damage, and an imbalanced inflammatory immune response, mainly manifesting as decreased levels of immune inflammatory cytokines. In addition, they suggest that certain liver and kidney function parameters and ALD severity are either positively or negatively correlated with certain inflammatory cytokines. Hence, ALD patients may be at increased risks of obesity- and inflammation-related diseases. Accordingly, to control the inflammatory response, preventative measures for patients with this disease should include weight control and protection of liver and kidney function.
酒精性肝病（ALD）与炎症反应之间的关联仍存在争议。本研究的目的是探讨ALD与炎症之间的这种关联。我们招募了214名男性参与者，他们被分为三个年龄匹配组：ALD组（n = 135）、无ALD的慢性酒精摄入组（非ALD组；n = 42）和对照组（n = 37）。ALD组的BMI显著高于非ALD组和对照组（所有P = 0.000）。此外，ALD组肝脏炎症水平的构成比显著高于非ALD组和对照组（分别为P = 0.002和P = 0.000）。此外，ALD组血清ALT、AST和GGT水平的中位数显著高于对照组（分别为P = 0.023、P = 0.008和P = 0.000）；这些水平在ALD组也显著高于非ALD组（分别为P = 0.013、P = 0.010和P = 0.000）。ALD组血清CRP水平的中位数显著高于非ALD组和对照组（分别为P = 0.006和P = 0.000）。此外，ALD组血清TNF-α水平的中位数显著低于非ALD组和对照组（分别为P = 0.004和P = 0.000）。ALD组血清sOX40L和HSP70水平的中位数显著低于对照组（分别为P = 0.008和P = 0.018）。此外，ALT、AST和GGT水平与CRP水平呈正相关（分别为r = 0.211，P = 0.002；r = 0.220，P = 0.001和r = 0.295，P = 0.000），GGT水平与TNF-α（r = -0.225，P = 0.001）、sOX40L（r = -0.165，P = 0.016）和HSP70水平呈负相关（r = -0.178，P = 0.009）。此外，Cr水平与IL-10水平呈负相关（r = -0.166，P = 0.015）。逻辑回归分析证实，ALD组的BMI（OR = 1.637，95%CI：1.374 - 1.951，P = 0.000）和GGT水平显著更高（OR = 1.039，95%CI：1.020 - 1.059，P = 0.000），而TNF-α（OR = 0.998，95%CI：0.996 - 1.000，P = 0.030）和HSP70水平显著更低（OR = 1.017，95%CI：1.003 - 1.031，P = 0.029）。此外，中重度ALD患者的血清CRP水平显著更高（Or = 1.349，95%CI：1.066 - 1.702，P = 0.013），而HSP60（OR = 0.965，95%CI：0.938 - 0.993，P = 0.014）和HSP70水平显著更低（OR = 0.978，95%CI：0.962 - 0.995，P = 0.010），与轻度ALD患者相比。这些结果表明，ALD患者可能存在肥胖、肝脏损伤和炎症免疫反应失衡，主要表现为免疫炎症细胞因子水平降低。此外，它们表明某些肝肾功能参数与ALD严重程度与某些炎症细胞因子呈正相关或负相关。因此，ALD患者可能面临与肥胖和炎症相关疾病的风险增加。因此，为了控制炎症反应，对该疾病患者的预防措施应包括控制体重和保护肝肾功能。
