Gender Specific Association of Serum Leptin and Insulinemic Indices with Nonalcoholic Fatty Liver Disease in Prediabetic Subjects
Gender Specific Association of Serum Leptin and Insulinemic Indices with Nonalcoholic Fatty Liver Disease in Prediabetic Subjects
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DOI：
10.1371/journal.pone.0142165
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发表时间：
2015-11-16
期刊：
影响因子：
3.7
通讯作者：
Ali, Liaquat
中科院分区：
文献类型：
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作者：
Hossain, Israt Ara;Akter, Salima;Ali, Liaquat
脂肪组织衍生激素瘦素通过影响胰岛素分泌和胰岛素敏感性在糖耐量中发挥作用，这也是非酒精性脂肪性肝病(NAFLD)的危险因素。本研究探讨了孟加拉糖尿病前期受试者血清瘦素和胰岛素指数与NAFLD的性别相关性。采用横断面分析设计，对110名25~68岁的糖尿病前期患者进行超声检查，其中男性占57.3%(非NAFLD占55.6%，NAFLD占44.4%)，女性占42.7%(非NAFLD占57.4%，NAFLD占42.6%)。通过稳态模型评估(HOMA)计算胰岛素分泌功能(HOMA%B)和胰岛素敏感性(HOMA%S)。男性糖尿病前期非酒精性脂肪肝患者血清瘦素水平与空腹胰岛素(r=0.530，P=0.004)、餐后胰岛素(r=0.384，P=0.042)、HOMA-IR(r=0.541，P=0.003)呈显著正相关，与HOMA%S(r=-0.388，P=0.046)、HOMA%B(r=-0.356，P=0.039)呈显著负相关。多元线性回归分析显示，在调整了体重指数、甘油三酯和HOMA%B的影响后，LOG转换后的瘦素与HOMA-IR呈显著正相关(β=0.706，P<；0.001)。经Logistic回归分析，男性仅对数瘦素[OR1.2995%(C.I)(1.11~1.51)，P=0.001]，HOMA%B[OR0.9495%(C.I)(0.89~0.98P=0.012)]，HOMA-IR[OR3.3095%(C.I.)(0.99~10.95)，调整体重指数和甘油三酯后，女性的对数瘦素[OR1.1095%(C.I)(1.01~1.20)，P=0.026]是非酒精性脂肪肝的独立危险因素。在男性和女性糖尿病前期受试者中，血清瘦素似乎与NAFLD有关联，而这种关联又是由这些受试者中的胰岛素分泌障碍和胰岛素抵抗所介导的。
Adipose tissue-derived hormone leptin plays a functional role in glucose tolerance through its effects on insulin secretion and insulin sensitivity which also represent the risk factors for nonalcoholic fatty liver disease (NAFLD). The present study explored the gender specific association of serum leptin and insulinemic indices with NAFLD in Bangladeshi prediabetic subjects. Under a cross-sectional analytical design a total of 110 ultrasound examined prediabetic subjects, aged 25-68 years consisting of 57.3% male (55.6% non NAFLD and 44.4% NAFLD) and 42.7% female (57.4% non NAFLD and 42.6% NAFLD), were investigated. Insulin secretory function (HOMA% B) and insulin sensitivity (HOMA% S) were calculated from homeostasis model assessment (HOMA). Serum leptin showed significant positive correlation with fasting insulin (r = 0.530, P = 0.004), postprandial insulin (r = 0.384, P = 0.042) and HOMA-IR (r = 0.541, P = 0.003) as well as significant negative correlation with HOMA% S (r = -0.388, P = 0.046) and HOMA% B (r = -0.356, P = 0.039) in male prediabetic subjects with NAFLD. In multiple linear regression analysis, log transformed leptin showed significant positive association with HOMA-IR (beta = 0.706, P < 0.001) after adjusting the effects of body mass index (BMI), triglyceride (TG) and HOMA% B in male subjects with NAFLD. In binary logistic regression analysis, only log leptin [OR 1.29 95% (C. I) (1.11-1.51), P = 0.001] in male subjects as well as HOMA% B [OR 0.94 95% (C. I) (0.89-0.98), P = 0.012], HOMA-IR [OR 3.30 95% (C. I) (0.99-10.95), P = 0.049] and log leptin [OR 1.10 95% (C. I) (1.01-1.20), P = 0.026] in female subjects were found to be independent determinants of NAFLD after adjusting the BMI and TG. Serum leptin seems to have an association with NAFLD both in male and female prediabetic subjects and this association in turn, is mediated by insulin secretory dysfunction and insulin resistance among these subjects.