Mathurin P, Vidaud D, Vidaud M, Bedossa P, Paradis V, Ratziu V, Chaput J C, Poynard T
URA CNRS, Paris, France.
Hepatology. 1996 Jan;23(1):44-51. doi: 10.1002/hep.510230107.
It has previously been shown that, in heavy drinkers, serum apolipoprotein A-I (ApoA-I) levels are closely related to the degree of liver injury: they are at a maximum in patients with steatosis, begin to decrease in patients with fibrosis, and reach a minimum in patients with severe cirrhosis. In contrast with serum ApoA-I variations, serum apolipoprotein B (ApoB) levels are stable. The assessment of messenger RNA (mRNA) levels of ApoA-I and ApoB using a quantitative competitive polymerase chain reaction (PCR) method was performed in 18 alcoholic patients: 8 with normal livers or steatosis (group I), 6 with fibrosis or nonsevere cirrhosis (group II), and 4 with severe cirrhosis (group III). For ApoA-I, group I had higher serum levels (208.4 +/- 37.6 mg/dL mean +/- SE) and mRNA levels (0.51 +/- 0.12) than group II (serum 116 +/- 19 mg/dL, P < .01, mRNA 0.40 +/- 0.11, P < .09) or group III (serum 56.5 +/- 28.6 mg/dL, P < .01, mRNA 0.27 +/- .02, P = .008). For ApoB, the three groups had similar serum ApoB levels: 129.9 +/- 37.7, 121 +/- 51, 120.7 +/- 57.4 mg/dL. Group I presented higher levels of ApoB mRNA than those of group III (0.68 +/- 0.21 vs. 0.41 +/- 0.18, P < .06). There was a significant correlation between serum and mRNA levels of ApoA-I (r = .65, P = .003) but no correlation between serum and mRNA levels of ApoB (r = .19, NS). We suggest that (1) steatosis is associated with increased ApoA-I mRNA; (2) fibrosis is associated with decreased serum ApoA-I, probably caused by a posttranscriptional mechanism; (3) severe alcohol-induced cirrhosis is associated with a nonspecific decrease in ApoA-I and ApoB mRNA; and (4) in contrast to ApoA-I mRNA, the ApoB mRNA level makes a slight contribution to the ApoB serum concentration.
先前的研究表明，在重度饮酒者中，血清载脂蛋白A-I（ApoA-I）水平与肝损伤程度密切相关：在脂肪变性患者中达到最高值，在纤维化患者中开始下降，在重度肝硬化患者中降至最低。与血清ApoA-I的变化相反，血清载脂蛋白B（ApoB）水平保持稳定。采用定量竞争聚合酶链反应（PCR）方法对18例酒精性肝病患者进行了ApoA-I和ApoB信使核糖核酸（mRNA）水平的评估：8例肝脏正常或有脂肪变性（I组），6例有纤维化或非重度肝硬化（II组），4例有重度肝硬化（III组）。对于ApoA-I，I组的血清水平（平均±标准误为208.4±37.6mg/dL）和mRNA水平（0.51±0.12）高于II组（血清116±19mg/dL，P<.01，mRNA 0.40±0.11，P<.09）或III组（血清56.5±28.6mg/dL，P<.01，mRNA 0.27±.02，P=.008）。对于ApoB，三组的血清ApoB水平相似：分别为129.9±37.7、121±51、120.7±57.4mg/dL。I组的ApoB mRNA水平高于III组（0.68±0.21对0.41±0.18，P<.06）。ApoA-I的血清水平与mRNA水平之间存在显著相关性（r=.65，P=.003），而ApoB的血清水平与mRNA水平之间无相关性（r=.19，无统计学意义）。我们认为：（1）脂肪变性与ApoA-I mRNA增加有关；（2）纤维化与血清ApoA-I降低有关，可能由转录后机制引起；（3）重度酒精性肝硬化与ApoA-I和ApoB mRNA的非特异性降低有关；（4）与ApoA-I mRNA不同，ApoB mRNA水平对ApoB血清浓度的影响较小。
