循环脂肪酸结合蛋白 4 水平是中老年人群代谢功能障碍相关脂肪性肝病的独立预测因子。
Circulating level of fatty acid-binding protein 4 is an independent predictor of metabolic dysfunction-associated fatty liver disease in middle-aged and elderly individuals.
机构信息
Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan.
出版信息
J Diabetes Investig. 2022 May;13(5):878-888. doi: 10.1111/jdi.13735. Epub 2022 Jan 3.
AIMS/INTRODUCTION: Metabolic dysfunction-associated fatty liver disease (MAFLD), defined as hepatosteatosis with type 2 diabetes mellitus, overweight/obesity or metabolic dysregulation, has been proposed as a new feature of chronic liver disease. Fatty acid-binding protein 4 (FABP4) is expressed in adipose tissue, and secreted FABP4 is associated with the development of insulin resistance and atherosclerosis. However, the relationship between MAFLD and FABP4 has not been fully addressed.
MATERIALS AND METHODS
Associations of MAFLD with metabolic markers, including FABP4, fibroblast growth factor 21 and adiponectin, were investigated in 627 individuals (men/women 292/335) in the Tanno-Sobetsu Study, a population-based cohort.
RESULTS
The mean age was 65 years (range 19-98 years, median [interquartile range] 68 [56-76] years). Hepatosteatosis was determined by the fatty liver index (FLI), and FLI ≥35 for men and FLI ≥16 for women were used for detection of fatty liver, as previously reported using 14,471 Japanese individuals. FLI was positively correlated with systolic blood pressure and levels of FABP4 (r = 0.331, P < 0.001), fibroblast growth factor 21, homeostasis model assessment of insulin resistance as an insulin resistance index and uric acid, and was negatively correlated with levels of high-density lipoprotein cholesterol and adiponectin. FABP4 concentration was independently associated with FLI after adjustment of age, sex, systolic blood pressure and levels of uric acid, high-density lipoprotein cholesterol, homeostasis model assessment of insulin resistance, adiponectin and fibroblast growth factor 21 in multivariable regression analysis. Logistic regression analysis showed that FABP4 was an independent predictor of MAFLD after adjustment of age, sex, presence of diabetes mellitus, hypertension and dyslipidemia, and levels of uric acid, homeostasis model assessment of insulin resistance, adiponectin and fibroblast growth factor 21.
CONCLUSIONS
FABP4 concentration is independently associated with FLI and is an independent predictor of MAFLD in middle-aged and elderly individuals.
目的/引言：代谢相关脂肪性肝病（MAFLD）定义为伴有 2 型糖尿病、超重/肥胖或代谢紊乱的肝脂肪变性，被认为是慢性肝病的一种新特征。脂肪酸结合蛋白 4（FABP4）在脂肪组织中表达，分泌的 FABP4 与胰岛素抵抗和动脉粥样硬化的发展有关。然而，MAFLD 与 FABP4 之间的关系尚未得到充分阐明。
材料和方法
在 Tanno-Sobetsu 研究中，对 627 名个体（男性/女性 292/335）进行了 MAFLD 与代谢标志物（包括 FABP4、成纤维细胞生长因子 21 和脂联素）的相关性研究。该研究是一个基于人群的队列。
结果
平均年龄为 65 岁（范围 19-98 岁，中位数[四分位数间距]68 [56-76]岁）。肝脂肪变性通过脂肪肝指数（FLI）确定，男性 FLI≥35 和女性 FLI≥16 用于检测脂肪肝，这是使用 14471 名日本人之前报道过的方法。FLI 与收缩压和 FABP4 水平呈正相关（r=0.331，P<0.001），与成纤维细胞生长因子 21、胰岛素抵抗的稳态模型评估作为胰岛素抵抗指数和尿酸呈负相关，与高密度脂蛋白胆固醇和脂联素水平呈负相关。在多变量回归分析中，在校正年龄、性别、收缩压和尿酸、高密度脂蛋白胆固醇、胰岛素抵抗的稳态模型评估、脂联素和成纤维细胞生长因子 21 水平后，FABP4 浓度与 FLI 独立相关。Logistic 回归分析显示，在校正年龄、性别、糖尿病、高血压和血脂异常、尿酸、胰岛素抵抗的稳态模型评估、脂联素和成纤维细胞生长因子 21 水平后，FABP4 是 MAFLD 的独立预测因子。
结论
FABP4 浓度与 FLI 独立相关，是中老年人 MAFLD 的独立预测因子。
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