Hua Man-Chin, Su Hui-Min, Yao Tsung-Chieh, Kuo Ming-Ling, Lai Ming-Wei, Tsai Ming-Han, Huang Jing-Long
Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.
Chang Gung University College of Medicine, Taoyuan, Taiwan.
PLoS One. 2017 Jul 31;12(7):e0182277. doi: 10.1371/journal.pone.0182277. eCollection 2017.
The aim of this study was to investigate changes in plasma fatty acids proportions and estimated desaturase activities for variable grading of liver steatosis in children.
In total, 111 schoolchildren (aged 8-18 years) were included in the analysis from March 2015 to August 2016. Anthropometric evaluation, liver ultrasound examination and scoring for nonalcoholic fatty liver disease (NAFLD score = 0-6), and biochemical and plasma fatty acids analysis were performed. We compared the composition ratio of fatty acids between children with high-grade liver steatosis (NAFLD score = 4-6), low-grade liver steatosis (NAFLD score = 1-3), and healthy controls (NAFLD score = 0). In addition, correlation coefficients (r) between NAFLD score, metabolic variables, and estimated activity of desaturase indices (stearoyl-coenzyme A desaturase-1 (SCD1), delta-5 and delta-6 desaturase) were calculated.
Compared with healthy controls, children with liver steatosis showed a higher proportion of monounsaturated fatty acids (21.16 ± 2.81% vs. 19.68 ± 2.71%, p = 0.024). In addition, children with high- grade liver steatosis exhibited higher proportions of palmitic acid (C16:0), palmitoleic acid (C16:1n-7), dihomo-γ-linolenic acid (C20:3n-6), adrenic acid (C22:4n-6), and docosapentaenoic acid (C22:5n-6); and lower proportions of eicosapentaenoic acid (C20:5n-3) (P< 0.05). In all subjects, the NAFLD score was positively correlated with body mass index (BMI) (kg/m2) (r = 0.696), homeostasis model of assessment ratio-index (HOMA-IR) (r = 0.510), SCD1(16) (r = 0.273), and the delta-6 index (r = 0.494); and inversely associated with the delta-5 index (r = -0.443).
Our current data suggested that children with liver steatosis was highly associated with obesity, and insulin resistance. In addition, increased endogenous lipogenesis through altered desaturase activity may contribute to the progression of liver steatosis in children.
本研究旨在调查儿童不同程度肝脂肪变性时血浆脂肪酸比例变化及估计的去饱和酶活性。
2015年3月至2016年8月，共纳入111名学龄儿童（8 - 18岁）进行分析。进行了人体测量评估、肝脏超声检查及非酒精性脂肪性肝病评分（NAFLD评分 = 0 - 6），并进行了生化和血浆脂肪酸分析。我们比较了重度肝脂肪变性儿童（NAFLD评分 = 4 - 6）、轻度肝脂肪变性儿童（NAFLD评分 = 1 - 3）和健康对照儿童（NAFLD评分 = 0）之间的脂肪酸组成比例。此外，计算了NAFLD评分、代谢变量与去饱和酶指数（硬脂酰辅酶A去饱和酶-1（SCD1）、δ-5和δ-6去饱和酶）估计活性之间的相关系数（r）。
与健康对照相比，肝脂肪变性儿童的单不饱和脂肪酸比例更高（21.16 ± 2.81%对19.68 ± 2.71%，p = 0.024）。此外，重度肝脂肪变性儿童的棕榈酸（C16:0）、棕榈油酸（C16:1n - 7）、二高-γ-亚麻酸（C20:3n - 6）、肾上腺酸（C22:4n - 6）和二十二碳五烯酸（C22:5n - 6）比例更高；而二十碳五烯酸（C20:5n - 3）比例更低（P < 0.05）。在所有受试者中，NAFLD评分与体重指数（BMI）（kg/m2）（r = 0.696）、稳态模型评估比率指数（HOMA-IR）（r = 0.510）、SCD1(16)（r = 0.273）和δ-6指数（r = 0.494）呈正相关；与δ-5指数呈负相关（r = -0.443）。
我们目前的数据表明，肝脂肪变性儿童与肥胖及胰岛素抵抗高度相关。此外，通过改变去饱和酶活性增加内源性脂肪生成可能有助于儿童肝脂肪变性的进展。
