Miura Kouichi, Arai Naoshi, Goka Rie, Morimoto Naoki, Watanabe Shunji, Isoda Norio, Yamamoto Hironori, Kotani Kazuhiko
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
Center for Community Medicine, Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
Antioxidants (Basel). 2021 Feb 4;10(2):239. doi: 10.3390/antiox10020239.
Patients with nonalcoholic fatty liver disease (NAFLD) show dyslipidemia and a high risk for coronary heart disease (CHD). However, conventional atherosclerotic lipids are found at low levels in NAFLD patients with advanced fibrosis, in whom the risk for CHD is extremely high. The aim of the present study was to evaluate the levels of oxidized high-density lipoprotein (oxHDL), an emerging atherosclerotic biomarker, in patients with NAFLD. A total of 32 non-NAFLD subjects and 106 patients with NAFLD were enrolled. The fibrosis grades were stratified using non-invasive methods, including the Fibrosis-4 index and NAFLD fibrosis score. Total cholesterol and low-density lipoprotein (LDL)-cholesterol levels were significantly low in patients with advanced liver fibrosis. In contrast, oxHDL levels were high in NAFLD patients and showed a stepwise increase as fibrosis progressed. These oxHDL levels were independent of the HDL cholesterol levels, and statin use did not influence the oxHDL levels. Obese patients showed no increase in oxHDL levels, whereas patients with a low handgrip strength showed high oxHDL levels in NAFLD with advanced fibrosis. In conclusion, oxHDL is a potential biomarker for assessing the status of patients with NAFLD, including CHD and metabolic/nutritional disturbance, and particular cases with advanced liver fibrosis.
非酒精性脂肪性肝病（NAFLD）患者存在血脂异常及冠心病（CHD）高风险。然而，在肝纤维化晚期的NAFLD患者中，传统的动脉粥样硬化血脂水平较低，但其冠心病风险极高。本研究旨在评估新兴的动脉粥样硬化生物标志物氧化型高密度脂蛋白（oxHDL）在NAFLD患者中的水平。共纳入32名非NAFLD受试者和106名NAFLD患者。采用包括Fibrosis-4指数和NAFLD纤维化评分在内的非侵入性方法对纤维化程度进行分层。肝纤维化晚期患者的总胆固醇和低密度脂蛋白（LDL）胆固醇水平显著降低。相反，NAFLD患者的oxHDL水平较高，且随着纤维化进展呈逐步升高。这些oxHDL水平与高密度脂蛋白胆固醇水平无关，他汀类药物的使用也不影响oxHDL水平。肥胖患者的oxHDL水平未升高，而握力较低的患者在晚期纤维化的NAFLD中oxHDL水平较高。总之，oxHDL是评估NAFLD患者状况（包括冠心病及代谢/营养紊乱）以及肝纤维化晚期特殊病例的潜在生物标志物。
