Araki Norimasa, Takahashi Hirokazu, Takamori Ayako, Kitajima Yoichiro, Hyogo Hideyuki, Sumida Yoshio, Tanaka Saiyu, Anzai Keizo, Aishima Shinichi, Chayama Kazuaki, Fujimoto Kazuma, Eguchi Yuichiro
Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.
Clinical Research Center Saga University Hospital Saga Japan.
JGH Open. 2020 Jun 9;4(5):929-936. doi: 10.1002/jgh3.12367. eCollection 2020 Oct.
Non-alcoholic fatty liver disease (NAFLD) is typically associated with metabolic syndrome and diabetes, and insulin resistance is involved in its pathogenesis. However, the relationship between insulin secretion and NAFLD is unclear. We aimed to characterize the relationship between fasting insulin secretory function (ISF), evaluated using the homeostatic model assessment-beta cell function (HOMA-β) and the severity of fibrosis during NAFLD.
A-β was calculated in 188 patients with biopsy-confirmed NAFLD, and the correlations between Log HOMA-β and clinical parameters, including hepatic fibrosis, were calculated.
Log HOMA-β was significantly lower in NAFLD patients with significant fibrosis (stages 2-4) than in those in the early stages (stages 0-1) (median [interquartile range]) (2.1 [1.9-2.4] 2.0 [1.8-2.2], = 0.04). The prevalence of significant fibrosis decreased with increasing Log HOMA-β: it was 59.2% in participants with low ISF (Log HOMA-β < 1.85), 43.6% in those with intermediate ISF (1.85 ≤ Log HOMA-β < 2.25), and 68.0% in those with high ISF (Log HOMA-β ≥ 2.25). Patients with lower Log HOMA-β had lower current body mass index (BMI), BMI at 20 years of age, and peak lifetime BMI than patients with intermediate or high Log HOMA-β.
Fasting ISF decreased alongside the development of liver fibrosis in NAFLD, suggesting that an impaired β cell function has a characteristic finding of significant liver fibrosis in relatively nonobese Japanese patients.
非酒精性脂肪性肝病（NAFLD）通常与代谢综合征和糖尿病相关，胰岛素抵抗参与其发病机制。然而，胰岛素分泌与NAFLD之间的关系尚不清楚。我们旨在通过稳态模型评估β细胞功能（HOMA-β）评估空腹胰岛素分泌功能（ISF）与NAFLD纤维化严重程度之间的关系。
计算188例经活检确诊的NAFLD患者的HOMA-β，并计算Log HOMA-β与包括肝纤维化在内的临床参数之间的相关性。
NAFLD显著纤维化（2-4期）患者的Log HOMA-β显著低于早期（0-1期）患者（中位数[四分位间距]）（2.1[1.9-2.4]对2.0[1.8-2.2]，P = 0.04）。显著纤维化的患病率随Log HOMA-β的增加而降低：低ISF（Log HOMA-β<1.85）参与者中为59.2%，中等ISF（1.85≤Log HOMA-β<2.25）参与者中为43.6%，高ISF（Log HOMA-β≥2.25）参与者中为68.0%。Log HOMA-β较低的患者当前体重指数（BMI）、20岁时的BMI和终生最高BMI均低于中等或高Log HOMA-β的患者。
NAFLD患者空腹ISF随着肝纤维化的发展而降低，提示β细胞功能受损是相对非肥胖日本患者显著肝纤维化的特征性表现。
