Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Liver Int. 2019 Mar;39(3):568-574. doi: 10.1111/liv.14021. Epub 2018 Dec 28.
BACKGROUND & AIMS: Serum adipocyte fatty acid-binding protein (A-FABP) is closely correlated to metabolic disorders such as obesity and insulin resistance (IR). Non-alcoholic fatty liver disease (NAFLD) is a typical feature of IR in the liver. The aim of this study was to explore the relationship between serum A-FABP levels and NAFLD.
The study enrolled 728 subjects with normal glucose tolerance from communities. Serum A-FABP levels were measured using a sandwich enzyme-linked immunosorbent assay. The liver fat content was assessed by ultrasonography. The fatty liver index (FLI) was calculated to quantify the degree of liver steatosis. The upper quartile of homoeostasis model assessment-insulin resistance (HOMA-IR) in the total population was defined as IR. Adipose tissue insulin resistance (Adipo-IR) was calculated to evaluate the impaired suppression of lipolysis in IR.
Serum A-FABP levels were significantly higher in subjects with NAFLD than in those without (P < 0.01). Moreover, subjects with IR had higher levels of A-FABP than those without (P < 0.01). The proportion of IR or NAFLD and the levels of fasting free fatty acid (FFA) or Adipo-IR displayed an upward trend as A-FABP increased (P for trend < 0.05). After adjusting for gender, age, body fat, metabolic factors and liver enzymes, A-FABP was independently correlated with NAFLD (P < 0.01). A-FABP was a positive determinant of FLI (P = 0.006).
Serum A-FABP levels were significantly elevated in NAFLD patients among a population with normal glucose tolerance. Serum A-FABP levels were independently correlated with NAFLD after adjusting for confounding factors.
血清脂肪细胞脂肪酸结合蛋白（A-FABP）与肥胖和胰岛素抵抗（IR）等代谢紊乱密切相关。非酒精性脂肪性肝病（NAFLD）是肝脏 IR 的典型特征。本研究旨在探讨血清 A-FABP 水平与 NAFLD 的关系。
本研究纳入了来自社区的 728 例糖耐量正常的受试者。采用夹心酶联免疫吸附法测定血清 A-FABP 水平。超声评估肝脂肪含量。计算脂肪肝指数（FLI）以量化肝脂肪变性程度。人群中稳态模型评估胰岛素抵抗（HOMA-IR）的四分位上限定义为 IR。计算脂肪组织胰岛素抵抗（Adipo-IR）以评估 IR 时脂解抑制受损情况。
NAFLD 患者的血清 A-FABP 水平明显高于无 NAFLD 者（P<0.01）。而且，IR 患者的 A-FABP 水平高于无 IR 者（P<0.01）。随着 A-FABP 水平的升高，IR 或 NAFLD 的比例以及空腹游离脂肪酸（FFA）或 Adipo-IR 的水平呈上升趋势（P 趋势<0.05）。在校正性别、年龄、体脂、代谢因素和肝酶后，A-FABP 与 NAFLD 独立相关（P<0.01）。A-FABP 是 FLI 的正相关因素（P=0.006）。
在糖耐量正常的人群中，NAFLD 患者的血清 A-FABP 水平显著升高。在校正混杂因素后，血清 A-FABP 水平与 NAFLD 独立相关。
