摘要
目的初步探讨非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)水平、慢性炎症反应及动脉粥样硬化的关系。方法 2016年10月-2017年2月采用横断面调查法,对成都市西安路社区医院体检的80例研究对象(其中NAFLD组40例NAFLD患者,对照组40例非脂肪肝者)进行GLP-1水平、慢性炎症反应及动脉粥样硬化的调查分析。结果与对照组比较,NAFLD患者GLP-1空腹水平[(9.09±1.03)、(9.15±1.06)pmol/L,P=0.807]和餐后2 h平[(15.96±3.37)、(17.46±4.76)pmol/L,P=0.108]均无明显变化,与慢性炎症、胰岛素抵抗(insulin resistance,IR)等也无明显相关性。NAFLD组颈动脉内-中膜厚度相关心血管疾病风险增加的人数多于对照组,差异有统计学意义[分别为22例(55.0%)和13例(32.5%),P=0.043]血浆脂蛋白相关磷脂酶A2水平升高时,NAFLD患病风险增加[比值比(odds ratio,OR)=1.16,95%置信区间(confidence interval,CI)(1.02,1.32),P=0.023]NAFLD组的空腹血浆神经酰胺激酶低于对照组,差异有统计学意义[(12.36±2.45)、(18.33±3.71)ng/mL,P<0.001]。空腹血浆神经酰胺激酶水平升高时,NAFLD患者风险下降[OR=0.30,95%CI(0.12,0.78),P=0.014]。NAFLD组稳态模型胰岛素抵抗评价指数(homeostasis model assessment of insulin resistance,HOMA-IR)高于对照组,差异有统计学意义(2.46±2.53、1.1 1±0.66,P=0.002)。NAFLD组Matsuda指数低于对照组,差异有统计学意义(5.88±4.09、10.46±7.90,P=0.002)。HOMA-IR增大,NAFLD患病风险增加[OR=2.75,95%CI(2.49,3.12),P=0.036]结论血浆GLP-1水平不是反映NAFLD患者慢性炎症、IR的敏感指标。NAFLD患者动脉粥样硬化及心血管疾病风险增加,推测与其慢性炎症反应、IR有关。慢性炎症可导致IR,慢性炎症和IR可引发NAFLD和亚临床动脉粥样硬化,NAFLD又加重慢性炎症和IR。
Objective To investigate and analyze the relationships among glucagon-like peptide-1（GLP-1） level,chronic inflammation, and atherosclerosis in patients with non-alcoholic fatty liver disease（NAFLD）. Methods From October 2016 to February 2017, using cross-sectional investigation, the GLP-1 level, chronic inflammation, and atherosclerosis were investigated in 80 subjects（40 NAFLD patients in NAFLD group, and 40 non-fatty liver disease participants in control group） who underwent physical examination at Xi＇an Road Community Hospital. Results Compared with those in the control group, GLP-1 fasting level in patients with NAFLD [（9.09± 1.03） vs.（9.15± 1.06） pmol/L,P=0.807] and postprandial plasma GLP-1 [（15.96±3.37） vs.（17.46±4.76） pmol/L, P=0.108] had no changes. The correlations of GLP-1 level with chronic inflammation and insulin resistance（IR） were not significant either. The increased risk of carotid intima-media thickness related cardiovascular disease（CVD） in the NAFLD group was greater than that in the control group, and the difference was statistically significant [22（55.0%） vs. 13（32.5%）, P=0.043]. When the plasma lipoprotein-associated phospholipase A2 level increased, the risk of NAFLD increased [odd ratio（OR）=1.16,95% confidence interval（CI）（1.02,1.32）, P=0.023]. Plasma ceramide kinase（CERK） in the NAFLD group was lower than that in the control group,and the difference was statistically significant [（12.36±2.45） vs.（18.33±3.71） ng/mL,P〈0.001],When the plasma CERK level of the fasting plasma was elevated, the risk of NAFLD decreased [OR=0.30, 95%CI（0.12,0.78）, P=0.014]. The homeostasis model assessment of insulin resistance（HOMA-IR） in the NAFLD group was higher than that in the control group, and the difference was statistically significant（2.46±2.53 vs. 1.11 ±0.66,P=0.002）. The Matsuda index in the NAFLD group was less than that in the control group, and the difference was statistically significant（5.88±4.09 vs.
作者
邓丽莎
董亚婕
吕庆国
万恒
鲁玉涛
向碧英
范秋艳
童南伟
DENG Lisha;DONGYajie;LU Qingguo;WAN Heng;LUYutao;XIANG Biying;FAN Qiuyan;TONG Nanwei(Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;Xi＇an Road Community Health Service Center, Chengdu, Sichuan 610072, P. R. China)
出处
《华西医学》
CAS
2018年第5期520-526,共7页
West China Medical Journal
基金
四川省科技支撑计划项目(2015SZ0228)
