非酒精性脂肪性肝病患者血清SHGB含量与胰岛素敏感性、脂代谢、氧化应激的相关性
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摘要
目的研究非酒精性脂肪性肝病(NAFLD)患者血清性激素结合球蛋白(SHGB)含量与胰岛素敏感性、脂代谢、氧化应激的相关性。方法设计回顾性研究,选择2017年2月至2018年2月期间常州市第三人民医院诊断为NAFLD的患者作为NAFLD组,同期在医院体检且肝功能正常、肝胆胰脾超声未见异常的志愿者作为对照组。比较两组血清中SHGB、空腹胰岛素(F-INS)、脂代谢指标、氧化应激指标的含量,计算胰岛素抵抗指数(HOMA-IR)及胰岛素敏感性指数(ISI)。结果 NAFLD组的血清SHGB、高密度脂蛋白胆固醇(HDL-C)、网膜素-1(Omentin-1)、脂联素(APN)、总超氧化物歧化酶(T-SOD)、过氧化氢酶(CAT)含量以及ISI水平低于对照组,血清F-INS、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、游离脂肪酸(FFA)、趋化素(Chemerin)、瘦素(LP)、丙二醛(MDA)、硫氧还蛋白互作蛋白(TXNIP)含量以及HOMA-IR水平高于对照组; NAFLD组的血清SHGB含量与HDL-C、Omentin-1、APN、T-SOD、CAT含量以及ISI水平呈正相关,与F-INS、TG、TC、LDL-C、FFA、Chemerin、LP、MDA、TXNIP以及HOMA-IR水平呈负相关。结论 NAFLD患者血清SHGB含量的降低与胰岛素敏感性降低、脂代谢紊乱、氧化应激激活密切相关。
Objective To study the correlation between serum sex hormone binding globulin( SHGB) with insulin sensitivity,lipid metabolism,oxidative stress in patients with nonalcoholic fatty liver disease( NAFLD). Methods Retrospective study was designed and the patients with NAFLD diagnosed in our hospital from February 2017 to February 2018 were selected as the NAFLD group,and the volunteers with normal liver function and no abnormalities in ultrasound were selected as the control group. The serum levels of SHGB,fasting insulin( F-INS),lipid metabolism and oxidative stress indexes were measured,and insulin resistance index( HOMA-IR) and insulin sensitivity index( ISI) were calculated. Results The serum contents of SHGB,HDL-C,Omentin-1,APN,T-SOD,catalase( CAT) and the level of ISI in NAFLD group were lower than those in control group,the serum contents of F-INS,triglyceride( TG),total cholesterol( TC),low density lipoprotein cholesterol( LDL-C),free fatty acid( FFA),chemokine( Chemerin),leptin( LP),malondialdehyde( MDA),thioredoxin interacting protein( TX-NIP) and the level of HOMA-IR were higher than those in control group,and the levels of SHGB in NAFLD group were positively correlated with HDL-C,Omentin-1,APN,T-SOD,CAT and ISI,negatively correlated with the levels of F-INS,TG,TC,LDL-C,FFA,Chemerin,LP,MDA,TXNIP and HOMA-IR. Conclusion The decrease of serum SHGB level in NAFLD patients closely correlates to insulin sensitivity,lipid metabolism disorder and oxidative stress activation.
Objective To study the correlation between serum sex hormone binding globulin( SHGB) with insulin sensitivity,lipid metabolism,oxidative stress in patients with nonalcoholic fatty liver disease( NAFLD). Methods Retrospective study was designed and the patients with NAFLD diagnosed in our hospital from February 2017 to February 2018 were selected as the NAFLD group,and the volunteers with normal liver function and no abnormalities in ultrasound were selected as the control group. The serum levels of SHGB,fasting insulin( F-INS),lipid metabolism and oxidative stress indexes were measured,and insulin resistance index( HOMA-IR) and insulin sensitivity index( ISI) were calculated. Results The serum contents of SHGB,HDL-C,Omentin-1,APN,T-SOD,catalase( CAT) and the level of ISI in NAFLD group were lower than those in control group,the serum contents of F-INS,triglyceride( TG),total cholesterol( TC),low density lipoprotein cholesterol( LDL-C),free fatty acid( FFA),chemokine( Chemerin),leptin( LP),malondialdehyde( MDA),thioredoxin interacting protein( TX-NIP) and the level of HOMA-IR were higher than those in control group,and the levels of SHGB in NAFLD group were positively correlated with HDL-C,Omentin-1,APN,T-SOD,CAT and ISI,negatively correlated with the levels of F-INS,TG,TC,LDL-C,FFA,Chemerin,LP,MDA,TXNIP and HOMA-IR. Conclusion The decrease of serum SHGB level in NAFLD patients closely correlates to insulin sensitivity,lipid metabolism disorder and oxidative stress activation.
引文
[1]Tomic D,Kemp WW,Roberts SK.Nonalcoholic fatty liver disease:current concepts,epidemiology and management strategies[J].Eur JGastroenterol Hepatol,2018,30(10):1103-1115.
[2]Dharmalingam M,Yamasandhi PG.Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus[J].Indian J Endocrinol Metab,2018,22(3):421-428.
[3]李曼,杨海燕,王惠,等.老年2型糖尿病患者血清性激素结合球蛋白与脂肪肝相关性研究[J].中国糖尿病杂志,2017,25(10):886-890.
[4]中华医学会肝病学分会脂肪肝和酒精性肝病学组中国医师协会脂肪性肝病专家委员会.非酒精性脂肪性肝病防治指南(2018年更新版)[J].临床肝胆病杂志,2018,34(5):947-957.
[5]Buzzetti E,Pinzani M,Tsochatzis EA.The multiple-hit pathogenesis of non-alcoholic fatty liver disease(NAFLD)[J].Metabolism,2016,65(8):1038-48.
[6]Gyawali P,Martin SA,Heilbronn LK,et al.The role of sex hormonebinding globulin(SHBG),testosterone,and other sex steroids,on the development of type 2 diabetes in a cohort of community-dwelling middle-aged to elderly men[J].Acta Diabetol,2018,55(8):861-872.
[7]Zhang T,Du T,Li W,et al.Sex hormone-binding globulin levels during the first trimester may predict gestational diabetes mellitus development[J].Biomark Med,2018,12(3):239-244.
[8]艾萍,廖映红.2型糖尿病合并非酒精性脂肪性肝病与血脂代谢紊乱的关系[J].中国老年医学,2016,36(2):327-329.
[9]Du T,Sun X,Yu X.Non-HDL cholesterol and LDL cholesterol in the dyslipidemic classification in patients with nonalcoholic fatty liver disease[J].Lipids Health Dis,2017,16(1):229.
[10]李敏,古丽娜孜·吐尔逊,段伯焕.2型糖尿病合并非酒精性脂肪性肝病患者A-FABP水平与胰岛素抵抗的相关性研究[J].临床和实验医学杂志,2017,16(15):1487-1490.
[11]Chen Q,Liu M,Yu H,et al.Scutellaria baicalensis regulates FFA metabolism to ameliorate NAFLD through the AMPK-mediated SREBPsignaling pathway[J].J Nat Med,2018,72(3):655-666.
[12]Zhang Z,Wang J,Wang H.Correlation of blood glucose,serum chemerin and insulin resistance with NAFLD in patients with type 2 diabetes mellitus[J].Exp Ther Med,2018,15(3):2936-2940.
[13]Alhasson F,Seth RK,Sarkar S,et al.High circulatory leptin mediated NOX-2-peroxynitrite-miR21 axis activate mesangial cells and promotes renal inflammatory pathology in nonalcoholic fatty liver disease[J].Redox Biol,2018,17:1-15.
[14]Boutari C,Perakakis N,Mantzoros CS.Association of Adipokines with Development and Progression of Nonalcoholic Fatty Liver Disease[J].Endocrinol Metab(Seoul),2018,33(1):33-43.
[15]Montazerifar F,Bakhshipour AR,Karajibani M,et al.Serum omentin-1,vaspin,and apelin levels and central obesity in patients with nonalcoholic fatty liver disease[J].J Res Med Sci,2017,30(22):70.
[16]谈力欣,刘焱,张秀云,等.2型糖尿病合并非酒精性脂肪肝患者炎性因子、氧化应激、硫氧还蛋白互作蛋白水平研究及相关性分析[J].河北医药,2018,40(9):1285-1289.
[17]Masarone M,Rosato V,Dallio M,et al.Role of Oxidative Stress in Pathophysiology of Nonalcoholic Fatty Liver Disease[J].Oxid Med Cell Longev,2018,11(2018):9547613.
[2]Dharmalingam M,Yamasandhi PG.Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus[J].Indian J Endocrinol Metab,2018,22(3):421-428.
[3]李曼,杨海燕,王惠,等.老年2型糖尿病患者血清性激素结合球蛋白与脂肪肝相关性研究[J].中国糖尿病杂志,2017,25(10):886-890.
[4]中华医学会肝病学分会脂肪肝和酒精性肝病学组中国医师协会脂肪性肝病专家委员会.非酒精性脂肪性肝病防治指南(2018年更新版)[J].临床肝胆病杂志,2018,34(5):947-957.
[5]Buzzetti E,Pinzani M,Tsochatzis EA.The multiple-hit pathogenesis of non-alcoholic fatty liver disease(NAFLD)[J].Metabolism,2016,65(8):1038-48.
[6]Gyawali P,Martin SA,Heilbronn LK,et al.The role of sex hormonebinding globulin(SHBG),testosterone,and other sex steroids,on the development of type 2 diabetes in a cohort of community-dwelling middle-aged to elderly men[J].Acta Diabetol,2018,55(8):861-872.
[7]Zhang T,Du T,Li W,et al.Sex hormone-binding globulin levels during the first trimester may predict gestational diabetes mellitus development[J].Biomark Med,2018,12(3):239-244.
[8]艾萍,廖映红.2型糖尿病合并非酒精性脂肪性肝病与血脂代谢紊乱的关系[J].中国老年医学,2016,36(2):327-329.
[9]Du T,Sun X,Yu X.Non-HDL cholesterol and LDL cholesterol in the dyslipidemic classification in patients with nonalcoholic fatty liver disease[J].Lipids Health Dis,2017,16(1):229.
[10]李敏,古丽娜孜·吐尔逊,段伯焕.2型糖尿病合并非酒精性脂肪性肝病患者A-FABP水平与胰岛素抵抗的相关性研究[J].临床和实验医学杂志,2017,16(15):1487-1490.
[11]Chen Q,Liu M,Yu H,et al.Scutellaria baicalensis regulates FFA metabolism to ameliorate NAFLD through the AMPK-mediated SREBPsignaling pathway[J].J Nat Med,2018,72(3):655-666.
[12]Zhang Z,Wang J,Wang H.Correlation of blood glucose,serum chemerin and insulin resistance with NAFLD in patients with type 2 diabetes mellitus[J].Exp Ther Med,2018,15(3):2936-2940.
[13]Alhasson F,Seth RK,Sarkar S,et al.High circulatory leptin mediated NOX-2-peroxynitrite-miR21 axis activate mesangial cells and promotes renal inflammatory pathology in nonalcoholic fatty liver disease[J].Redox Biol,2018,17:1-15.
[14]Boutari C,Perakakis N,Mantzoros CS.Association of Adipokines with Development and Progression of Nonalcoholic Fatty Liver Disease[J].Endocrinol Metab(Seoul),2018,33(1):33-43.
[15]Montazerifar F,Bakhshipour AR,Karajibani M,et al.Serum omentin-1,vaspin,and apelin levels and central obesity in patients with nonalcoholic fatty liver disease[J].J Res Med Sci,2017,30(22):70.
[16]谈力欣,刘焱,张秀云,等.2型糖尿病合并非酒精性脂肪肝患者炎性因子、氧化应激、硫氧还蛋白互作蛋白水平研究及相关性分析[J].河北医药,2018,40(9):1285-1289.
[17]Masarone M,Rosato V,Dallio M,et al.Role of Oxidative Stress in Pathophysiology of Nonalcoholic Fatty Liver Disease[J].Oxid Med Cell Longev,2018,11(2018):9547613.