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印度东部非酒精性脂肪性肝病患者的生化特征及其与组织病理学的相关性

Biochemical Profile of Nonalcoholic Fatty Liver Disease Patients in Eastern India with Histopathological Correlation.

作者信息

Swain Manorama, Nath Preetam, Parida Prasant Kumar, Narayan Jimmy, Padhi Pradeep Kumar, Pati Girish Kumar, Singh Ayaskanta, Misra Bijay, Misra Debasis, Kar Sanjib Kumar, Panigrahi Manas Kumar, Meher Chudamani, Agrawal Omprakash, Rout Niranjan, Pattnaik Kaumudee, Bhuyan Pallavi, Mishra Pramila Kumari, Singh Shivaram Prasad

机构信息

Department of Biochemistry, S.C.B. Medical College, Cuttack, Odisha 753007 India.

Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India.

出版信息

Indian J Clin Biochem. 2017 Jul;32(3):306-314. doi: 10.1007/s12291-016-0612-7. Epub 2016 Sep 3.

Abstract

Aminotransferase assay is often used as a screening test as well as an endpoint for resolution of disease in nonalcoholic fatty liver disease (NAFLD). Aim of the study was to evaluate the relationship of transaminase level with metabolic variables and histology in NAFLD. Single center observational study was conducted in a gastroenterology clinic at Cuttack in coastal Odisha. Subjects were consecutive patients presenting with functional bowel disease and undergoing abdominal sonography. All participants were evaluated for the presence of metabolic syndrome (MS), insulin resistance, liver function test and lipid profile. Various parameters were compared between NAFLD subjects and controls. 53.5 % of NAFLD had normal serum transaminases, whereas 20.8 % of healthy controls had transaminitis. NAFLD patients had significantly higher BMI, fasting plasma glucose, serum transaminases, serum triglycerides, serum insulin and homeostatic model assessment (HOMA) IR than controls. NAFLD patients who had transaminitis had significantly higher incidence of MS and higher mean HOMA IR than those without. There was no significant difference in histopathological features between NAFLD with and without transaminitis. To conclude, over half of NAFLD subjects do not have transaminitis while transaminitis is present in a fifth of healthy people without fatty liver. Hence serum transaminase should not be used as screening test for NAFLD. NAFLD patients with transaminitis had a higher incidence of MS and insulin resistance than those without. However, there was no significant difference in histopathological features between these two groups.

摘要

转氨酶检测通常用作非酒精性脂肪性肝病(NAFLD)的筛查试验以及疾病缓解的终点指标。本研究的目的是评估NAFLD中转氨酶水平与代谢变量及组织学之间的关系。在奥里萨邦沿海城市库塔克的一家胃肠病诊所进行了单中心观察性研究。研究对象为连续就诊的功能性肠病患者且均接受了腹部超声检查。对所有参与者进行了代谢综合征(MS)、胰岛素抵抗、肝功能检查及血脂谱评估。比较了NAFLD患者与对照组之间的各项参数。53.5%的NAFLD患者血清转氨酶正常,而20.8%的健康对照者存在转氨酶升高。NAFLD患者的体重指数、空腹血糖、血清转氨酶、血清甘油三酯、血清胰岛素及稳态模型评估(HOMA)胰岛素抵抗(IR)均显著高于对照组。转氨酶升高的NAFLD患者MS发病率及平均HOMA IR均显著高于转氨酶正常者。转氨酶升高与未升高的NAFLD患者组织病理学特征无显著差异。总之,超过半数的NAFLD患者不存在转氨酶升高,而五分之一无脂肪肝的健康人存在转氨酶升高。因此,血清转氨酶不应作为NAFLD的筛查试验。转氨酶升高的NAFLD患者MS及胰岛素抵抗的发生率高于转氨酶正常者。然而,这两组患者的组织病理学特征无显著差异。

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