Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
Department of Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ, USA.
Clin Mol Hepatol. 2018 Dec;24(4):392-401. doi: 10.3350/cmh.2018.0011. Epub 2018 Aug 2.
BACKGROUND/AIMS: Leptin is associated with metabolic disorders, which predispose one to non-alcoholic fatty liver disease (NAFLD). The role of leptin in NAFLD pathogenesis is not fully understood. We aim to investigate the association between serum leptin level and severity of NAFLD using U.S. nationally representative data.
Data were obtained from the United States Third National Health and Nutrition Examination Survey. NAFLD was defined by ultrasound detection and severity of hepatic steatosis in the absence of other liver diseases. The severity of hepatic fibrosis was determined by NAFLD fibrosis score (NFS). We used multivariate survey-weighted generalized logistic regression to evaluate the association between leptin level and the degree of NAFLD. We also performed subgroup analyses by body mass index (lean vs. classic NAFLD).
Among 4,571 people, 1,610 (35%) had NAFLD. By ultrasound findings, there were 621 people with mild, 664 with moderate, and 325 with severe steatosis. There were 885 people with low NFS (<-1.455, no significant fibrosis), 596 with intermediate NFS, and 129 with high NFS (>0.676, advanced fibrosis). Leptin levels for normal, mild, moderate and severe steatosis were 10.7±0.3 ng/mL, 12.1±0.7 ng/mL, 15.6±0.8 ng/mL, 16±1.0 ng/mL, respectively (trend P-value<0.001). Leptin levels for low, intermediate, and high NFS were 11.8±0.5 ng/mL, 15.6±0.8 ng/mL, 28.5±3.5ng/mL, respectively (trend P-value<0.001). This association remained significant even after adjusting for known demographic and metabolic risk factors. In the subgroup analysis, this association was only prominent in classic NAFLD, but not in lean NAFLD.
Serum leptin level is associated with the severity of NAFLD, especially in classic NAFLD patients.
背景/目的：瘦素与代谢紊乱有关，后者使人们易患非酒精性脂肪性肝病（NAFLD）。瘦素在 NAFLD 发病机制中的作用尚不完全清楚。我们旨在使用美国具有全国代表性的数据来研究血清瘦素水平与 NAFLD 严重程度之间的关系。
数据来自美国第三次国家健康和营养检查调查。NAFLD 通过超声检测和无其他肝病的情况下肝脂肪变性的严重程度来定义。肝纤维化的严重程度通过 NAFLD 纤维化评分（NFS）确定。我们使用多变量调查加权广义逻辑回归来评估瘦素水平与 NAFLD 程度之间的关系。我们还按体重指数（瘦素与经典 NAFLD）进行了亚组分析。
在 4571 人中，有 1610 人（35％）患有 NAFLD。根据超声检查结果，有 621 人患有轻度脂肪变性，664 人患有中度脂肪变性，325 人患有重度脂肪变性。有 885 人 NFS 较低（<-1.455，无显著纤维化），596 人 NFS 中等，129 人 NFS 较高（>0.676，晚期纤维化）。正常、轻度、中度和重度脂肪变性的瘦素水平分别为 10.7±0.3ng/mL、12.1±0.7ng/mL、15.6±0.8ng/mL、16±1.0ng/mL（趋势 P 值<0.001）。低、中、高 NFS 的瘦素水平分别为 11.8±0.5ng/mL、15.6±0.8ng/mL、28.5±3.5ng/mL（趋势 P 值<0.001）。即使在调整了已知的人口统计学和代谢危险因素后，这种关联仍然具有统计学意义。在亚组分析中，这种关联仅在经典 NAFLD 中明显，而在瘦素 NAFLD 中则不明显。
血清瘦素水平与 NAFLD 的严重程度有关，尤其是在经典 NAFLD 患者中。
