Xu Ziwei, Sun Yueming
Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University.
Department of Surgery, Jinling Hospital, Nanjing University School of Medicine.
J Nutr Sci Vitaminol (Tokyo). 2019;65(1):24-30. doi: 10.3177/jnsv.65.24.
Parenteral nutrition-associated liver disease, a common and life-threating complication among people who require long-term parenteral nutrition, has been associated with abnormal liver function, cholestasis, steatosis and fibrosis. Intravenous soybean lipids may be associated with the development of liver disease. We therefore examined whether different doses of parenteral lipids would affect the development of liver disease, and further investigated the possible pathogenesis of it. C57BL/6J mice with a central catheter placed in the right jugular vein were divided into three groups. The control group received normal mouse chow with intravenous normal saline; The lipids group received parenteral nutrition solution (0.14 g lipids per day); the H-lipids group received parenteral nutrition solution with twice the amount of lipids (0.3 g lipids per day). Changes in body weight, serum biochemical parameters, liver histology and farnesoid X receptor gene expression in the liver were assessed. The values of serum direct bilirubin, total bilirubin and cholesterol were markedly increased in the H-lipids group at day 7. The predominant histologic finding in the H-lipids group was steatosis, and the steatosis score in the H-lipids group was much higher than in the other two groups at either day 5 or day 7. Hepatic expression of farnesoid X receptor mRNA decreased after 7 d of parenteral nutrition. High doses of parenteral lipids are more likely to develop liver disease in a mouse model of parenteral nutrition. Farnesoid X receptor may play a key role in the development of parenteral nutrition-associated liver disease.
肠外营养相关肝病是长期接受肠外营养患者中常见且危及生命的并发症,与肝功能异常、胆汁淤积、脂肪变性和纤维化有关。静脉输注大豆脂质可能与肝病的发生有关。因此,我们研究了不同剂量的肠外脂质是否会影响肝病的发生,并进一步探讨其可能的发病机制。将右颈静脉置有中心导管的C57BL/6J小鼠分为三组。对照组给予正常小鼠饲料并静脉输注生理盐水;脂质组给予肠外营养溶液(每天0.14 g脂质);高剂量脂质组给予脂质含量两倍的肠外营养溶液(每天0.3 g脂质)。评估体重、血清生化参数、肝脏组织学以及肝脏中法尼酯X受体基因表达的变化。在第7天,高剂量脂质组的血清直接胆红素、总胆红素和胆固醇值显著升高。高剂量脂质组的主要组织学表现为脂肪变性,在第5天或第7天,高剂量脂质组的脂肪变性评分远高于其他两组。肠外营养7天后,肝脏中法尼酯X受体mRNA的表达下降。在肠外营养小鼠模型中,高剂量的肠外脂质更易引发肝病。法尼酯X受体可能在肠外营养相关肝病的发生中起关键作用。