Miyake Teruki, Furukawa Shinya, Matsuura Bunzo, Yoshida Osamu, Miyazaki Masumi, Shiomi Akihito, Kanzaki Sayaka, Nakaguchi Hironobu, Sunago Kotaro, Nakamura Yoshiko, Imai Yusuke, Watanabe Takao, Yamamoto Yasunori, Koizumi Yohei, Tokumoto Yoshio, Hirooka Masashi, Kumagi Teru, Abe Masanori, Hiasa Yoichi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon 791-0295, Ehime, Japan.
Health Services Center, Ehime University, Bunkyo, Matsuyama 790-8577, Ehime, Japan.
Biomedicines. 2022 Oct 12;10(10):2540. doi: 10.3390/biomedicines10102540.
The relationship between advanced nonalcoholic steatohepatitis (NASH) and plasma fatty acid composition remains unknown. We aimed to examine the plasma fatty acid composition in biopsy-confirmed nonalcoholic fatty liver disease (NAFLD) and evaluate the relationship between histological findings and fatty acid composition. Overall, 235 patients (134 women) with NAFLD were enrolled. Comprehensive blood chemistry tests and histological examinations of liver samples were conducted. Multivariate analyses adjusted for age, sex, body mass index, alanine aminotransferase, hemoglobin A1c, creatinine, total cholesterol, triglyceride, and NAFLD Activity Score values showed that lower levels of arachidic, behenic, α-linolenic, eicosatetraenoic, docosapentaenoic, and docosahexaenoic acids and higher levels of mead acid were associated with fibrosis stage 3-4. Furthermore, higher lauric acid, myristic acid, and palmitic acid levels and monounsaturated fatty acids such as palmitoleic acid and oleic acid were significantly associated with high NAS in analyses adjusted for the same factors and fibrosis stage. The plasma fatty acid composition was associated with the histological evidence of NASH. Increased synthesis of fatty acids is associated with NASH; insufficient intake of n-3 essential fatty acids and reduced elongation of fatty acids are associated with fibrosis in NASH. These features may help clinicians to understand and treat advanced NASH cases.
晚期非酒精性脂肪性肝炎（NASH）与血浆脂肪酸组成之间的关系尚不清楚。我们旨在研究经活检确诊的非酒精性脂肪性肝病（NAFLD）患者的血浆脂肪酸组成，并评估组织学检查结果与脂肪酸组成之间的关系。共有235例NAFLD患者（134例女性）入组。进行了全面的血液生化检查和肝组织样本的组织学检查。对年龄、性别、体重指数、丙氨酸转氨酶、糖化血红蛋白、肌酐、总胆固醇、甘油三酯和NAFLD活动评分值进行多变量分析后发现，花生酸、山嵛酸、α-亚麻酸、二十碳四烯酸、二十二碳五烯酸和二十二碳六烯酸水平较低以及麦迪酸水平较高与3-4期纤维化相关。此外，在对相同因素和纤维化分期进行校正的分析中，月桂酸、肉豆蔻酸和棕榈酸水平较高以及棕榈油酸和油酸等单不饱和脂肪酸与高NAFLD活动评分显著相关。血浆脂肪酸组成与NASH的组织学证据相关。脂肪酸合成增加与NASH相关；n-3必需脂肪酸摄入不足和脂肪酸延长减少与NASH中的纤维化相关。这些特征可能有助于临床医生理解和治疗晚期NASH病例。
