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非酒精性脂肪性肝炎患者体重减轻后的生化参数反应

Biochemical parameters response to weight loss in patients with non-alcoholic steatohepatitis.

作者信息

Abd El-Kader Shehab M, Al-Shreef Fadwa M, Al-Jiffri Osama H

机构信息

Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University.

Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University.

出版信息

Afr Health Sci. 2016 Mar;16(1):242-9. doi: 10.4314/ahs.v16i1.32.

Abstract

BACKGROUND

Non-alcoholic steatohepatitis (NASH) is a chronic liver disease that is capable of progressing to end-stage liver disease, but generally has a benign course. Non-alcoholic steatohepatitis (NASH) is a growing public health problem with no approved therapy. NASH projected to be the leading cause of liver transplantation in the United States by 2020. Obesity, non-insulin-dependent diabetes mellitus and hyperlipidaemia are the most common associations of the disease. Global prevalence of NASH is 10-24% amongst general population but increases to 25-75% in obese diabetic individuals.

OBJECTIVE

There is an urgent need for efficient therapeutic options as there is still no approved medication. The aim of this study was to detect changes in biochemical parameters including insulin resistance, cytokines, blood lipid profile and liver enzymes following weight loss in patients with non-alcoholic steatohepatitis.

MATERIALS AND METHODS

One hundred obese patients with NASH, their age between 35-50 years, body mass index (BMI) from 30 to 35 Kg/m(2) were included in the study in two subgroups; the first group (A) received moderate aerobic exercise training in addition to diet regimen , where the second group (B) received no treatment intervention.

RESULTS

The mean values of leptin, TNF-α, IL6, IL8, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Homeostasis Model Assessment-Insulin Resistance- index (HOMA-IR), Total Cholesterol (TC), Low Density Lipoprotein Cholesterol (LDL-c) , Triglycerides (TG) and BMI were significantly decreased in group (A), where the mean value of Adiponectin and High Density Lipoprotein Cholesterol (HDL-c) were significantly increased, while there were no significant changes in group (B). Also, there was a significant difference between both groups at the end of the study.

CONCLUSION

Weight loss modulates insulin resistance, adiponectin, leptin, inflammatory cytokine levels and markers of hepatic function in patients with nonalcoholic steatohepatitis.

摘要

背景

非酒精性脂肪性肝炎(NASH)是一种慢性肝病,能够进展为终末期肝病,但通常病程呈良性。非酒精性脂肪性肝炎(NASH)是一个日益严重的公共卫生问题,目前尚无获批的治疗方法。预计到2020年,NASH将成为美国肝移植的主要原因。肥胖、非胰岛素依赖型糖尿病和高脂血症是该疾病最常见的相关因素。NASH在普通人群中的全球患病率为10%-24%,但在肥胖糖尿病个体中增至25%-75%。

目的

由于仍没有获批的药物,迫切需要有效的治疗选择。本研究的目的是检测非酒精性脂肪性肝炎患者体重减轻后生化参数的变化,包括胰岛素抵抗、细胞因子、血脂谱和肝酶。

材料与方法

100例年龄在35-50岁、体重指数(BMI)为30至35kg/m²的肥胖NASH患者被纳入研究,分为两个亚组;第一组(A组)除饮食方案外还接受中等强度有氧运动训练,第二组(B组)不接受治疗干预。

结果

A组中瘦素、TNF-α、IL6、IL8、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、稳态模型评估胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、甘油三酯(TG)和BMI的平均值显著降低,而脂联素和高密度脂蛋白胆固醇(HDL-c)的平均值显著升高,而B组无显著变化。此外,研究结束时两组之间存在显著差异。

结论

体重减轻可调节非酒精性脂肪性肝炎患者的胰岛素抵抗、脂联素、瘦素、炎性细胞因子水平和肝功能指标。

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