Mochizuki Kohei, Higa Mariko, Ikehara Kayoko, Ichijo Takamasa, Hirose Takahisa
Division of Diabetes and Endocrinology, Department of Medicine, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan.
Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.
Diabetol Int. 2024 Nov 23;16(1):107-114. doi: 10.1007/s13340-024-00760-3. eCollection 2025 Jan.
An elevated level of saturated fatty acids (SFAs) can cause non-alcoholic fatty liver disease (NAFLD). While n-3 polyunsaturated fatty acids (PUFAs) were shown to improve NAFLD, the effects of n-6 PUFAs in the liver have not been fully elucidated. We examined the association between NAFLD and n-6 PUFAs, particularly dihomo-γ-linolenic acid (DGLA), in patients with type 2 diabetes. A total of 60 patients with type 2 diabetes were included in the study. Patients were categorized into the NAFLD group ( = 35) and non-NAFLD group ( = 25) based on the presence of fatty liver as determined by abdominal ultrasound. We demonstrated that the levels of serum SFAs, specifically palmitic acid and stearic acid, and the levels of n-6 PUFAs, specifically DGLA, and arachidonic acid (AA), were significantly higher in the NAFLD group. The serum palmitic acid, stearic acid, DGLA and AA levels were positively correlated with liver enzyme gamma-glutamyl transpeptidase (GGT). We further demonstrated by multivariate analysis that serum DGLA was a predictor of NAFLD. The serum DGLA level was negatively correlated with blood adiponectin and was positively correlated with blood leptin, high-sensitivity CRP, C-peptide index, and triglyceride-glucose index. Furthermore, delta-5-desaturase (D5D), the AA (product)/DGLA (precursor) ratio calculated from the product-to-precursor ratio of fatty acids, was significantly lower in the NAFLD group. These findings suggest that high serum DGLA levels in NAFLD group may be due to an excessive intake of n-6 PUFAs and changes in desaturase in the human body. High serum DGLA levels may also be associated with insulin resistance and inflammatory factors.
饱和脂肪酸(SFA)水平升高可导致非酒精性脂肪性肝病(NAFLD)。虽然n-3多不饱和脂肪酸(PUFA)已被证明可改善NAFLD,但n-6多不饱和脂肪酸在肝脏中的作用尚未完全阐明。我们研究了2型糖尿病患者中NAFLD与n-6多不饱和脂肪酸,特别是二高-γ-亚麻酸(DGLA)之间的关联。本研究共纳入60例2型糖尿病患者。根据腹部超声检查确定的脂肪肝情况,将患者分为NAFLD组(n = 35)和非NAFLD组(n = 25)。我们发现,NAFLD组的血清饱和脂肪酸水平,特别是棕榈酸和硬脂酸水平,以及n-6多不饱和脂肪酸水平,特别是DGLA和花生四烯酸(AA)水平,均显著升高。血清棕榈酸、硬脂酸、DGLA和AA水平与肝酶γ-谷氨酰转肽酶(GGT)呈正相关。我们通过多变量分析进一步证明,血清DGLA是NAFLD的一个预测指标。血清DGLA水平与血液中脂联素呈负相关,与血液中瘦素、高敏CRP、C肽指数和甘油三酯-葡萄糖指数呈正相关。此外,根据脂肪酸的产物与前体比例计算得出的AA(产物)/DGLA(前体)比值,即δ-5-去饱和酶(D5D),在NAFLD组中显著降低。这些发现表明,NAFLD组血清DGLA水平升高可能是由于n-6多不饱和脂肪酸摄入过多以及人体去饱和酶变化所致。血清DGLA水平升高也可能与胰岛素抵抗和炎症因子有关。