血清催乳素与 2 型糖尿病女性患者代谢相关脂肪性肝病之间的 J 形关系。
J-Shaped Relationship Between Serum Prolactin and Metabolic-Associated Fatty Liver Disease in Female Patients With Type 2 Diabetes.
机构信息
Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
National Metabolic Management Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
出版信息
Front Endocrinol (Lausanne). 2022 Feb 11;13:815995. doi: 10.3389/fendo.2022.815995. eCollection 2022.
BACKGROUND
Metabolic-associated fatty liver disease (MAFLD) has become a worldwide epidemic. Prolactin (PRL), a pituitary hormone, has been linked to MAFLD. As a result, we set out to look into the relationship between serum PRL and the risk of MAFLD in patients with type 2 diabetes mellitus (T2DM).
METHODS
A total of 724 adults with T2DM were enrolled and categorized as MAFLD and non-MAFLD groups. Anthropometric data, biochemical parameters, and serum PRL levels were collected. Liver steatosis and fibrosis were assessed using FibroScan. Patients were stratified into normal PRL (NP) and high PRL (HP) groups and divided into four groups based on serum PRL quartiles. Multivariate logistic regression analysis was performed to evaluate the association between serum PRL and MAFLD risk.
RESULTS
Female but not male patients with MAFLD, liver steatosis, and fibrosis had significantly lower PRL levels in the NP group but higher PRL levels in the HP group than their counterparts. The proportions of MAFLD, liver steatosis, and fibrosis were significantly decreased in the NP group but increased in the HP group across the PRL quartiles in females but not in males. After multivariate adjustment, the adjusted ORs (AORs) and 95% CI for MAFLD among females were 18.165 (3.425-96.336), 1.784 (0.658-5.002), 1.744 (0.608-4.832), and 1.00 (reference) in the NP group (Q1-Q4, -trend 0.001) and 1.00 (reference), 11.098 (1.819-110.356), 15.225 (1.996-116.112), and 18.211 (2.579-128.568) in the HP group (Q1-Q4, -trend = 0.020). Such associations were also found between serum PRL and liver fibrosis in females but not in males.
CONCLUSION
We observed a J-shaped association between serum PRL and the risk of MAFLD and liver fibrosis in females but not in males with T2DM, indicating that PRL may be relevant to MAFLD and its progression in a gender-specific manner.
CLINICAL TRIAL REGISTRATION
Chinese Clinical Trial Registry, number ChiCTR-OCS-12002381.
背景
代谢相关脂肪性肝病（MAFLD）已成为全球性流行疾病。催乳素（PRL）是一种垂体激素，与 MAFLD 有关。因此，我们研究了 2 型糖尿病（T2DM）患者血清 PRL 与 MAFLD 风险之间的关系。
方法
共纳入 724 例 T2DM 成年患者，分为 MAFLD 和非 MAFLD 组。收集人体测量学数据、生化参数和血清 PRL 水平。使用 FibroScan 评估肝脂肪变性和纤维化。根据正常 PRL（NP）和高 PRL（HP）组将患者分层，并根据血清 PRL 四分位值将患者分为四组。采用多变量 logistic 回归分析评估血清 PRL 与 MAFLD 风险之间的关系。
结果
女性 MAFLD、肝脂肪变性和纤维化患者的 NP 组血清 PRL 水平显著低于非 MAFLD 患者，但 HP 组血清 PRL 水平显著高于非 MAFLD 患者。女性 NP 组 PRL 四分位值越高，MAFLD、肝脂肪变性和纤维化的比例越高，而 HP 组则越低。校正多变量后，女性 MAFLD 的校正比值比（AOR）和 95%可信区间（95%CI）在 NP 组分别为 18.165（3.425-96.336）、1.784（0.658-5.002）、1.744（0.608-4.832）和 1.00（参考）（Q1-Q4，-趋势 0.001），而 HP 组分别为 1.00（参考）、11.098（1.819-110.356）、15.225（1.996-116.112）和 18.211（2.579-128.568）（Q1-Q4，-趋势=0.020）。在女性中，也观察到血清 PRL 与肝纤维化之间存在类似的关联，但在男性中则没有。
结论
我们观察到 2 型糖尿病女性患者血清 PRL 与 MAFLD 和肝纤维化风险之间呈 J 型关联，但男性患者则没有。这表明 PRL 可能以性别特异性方式与 MAFLD 及其进展相关。
临床试验注册
中国临床试验注册中心，注册号 ChiCTR-OCS-12002381。
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