Jin R, Krasinskas A, Le N-A, Konomi J V, Holzberg J, Romero R, Vos M B
Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA.
Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA.
Pediatr Obes. 2018 Jan;13(1):23-29. doi: 10.1111/ijpo.12183. Epub 2016 Oct 20.
Plasminogen activator inhibitor-1 (PAI-1) is the primary inhibitor of the endogenous fibrinolytic system and is known to be increased in obesity, insulin resistance and non-alcoholic fatty liver disease (NAFLD). We previously demonstrated that PAI-1 levels were closely related to the amount of hepatic steatosis in children.
The aim of this study was to characterize plasma PAI-1 in relationship to severity of inflammation and fibrosis, as well as to plasma lipids in children with NAFLD.
In 44 children with NAFLD, plasma PAI-1 levels and lipids were measured at the time of a liver biopsy. Hepatic histological features were systematically scored. Trend analysis was applied to determine the correlation of plasma PAI-1 levels with lipid markers for cardiovascular disease and with the staging of histological features in the liver.
We found that plasma PAI-1 levels were significantly increased in children with increased severity of steatosis, lobular inflammation, ballooning and fibrosis. Furthermore, PAI-1 was strongly correlated with plasma lipids and insulin resistance indices.
PAI-1 appears to be tightly related to both histologic severity of NAFLD as well as systemic features of the disease including insulin resistance and dyslipidemia. PAI-1 may be a mediator of disease progression and future cardiovascular complications in children with NAFLD.
纤溶酶原激活物抑制剂-1（PAI-1）是内源性纤维蛋白溶解系统的主要抑制剂，已知在肥胖、胰岛素抵抗和非酒精性脂肪性肝病（NAFLD）中会升高。我们之前证明，PAI-1水平与儿童肝脏脂肪变性的程度密切相关。
本研究的目的是描述NAFLD儿童血浆PAI-1与炎症和纤维化严重程度以及血浆脂质之间的关系。
对44名NAFLD儿童在进行肝活检时测量血浆PAI-1水平和脂质。对肝脏组织学特征进行系统评分。应用趋势分析来确定血浆PAI-1水平与心血管疾病脂质标志物以及肝脏组织学特征分期之间的相关性。
我们发现，在脂肪变性、小叶炎症、气球样变和纤维化严重程度增加的儿童中，血浆PAI-1水平显著升高。此外，PAI-1与血浆脂质和胰岛素抵抗指数密切相关。
PAI-1似乎与NAFLD的组织学严重程度以及该疾病的全身特征（包括胰岛素抵抗和血脂异常）密切相关。PAI-1可能是NAFLD儿童疾病进展和未来心血管并发症的介质。
