Clinical usefulness of non-protein respiratory quotient measurement in non-alcoholic fatty liver disease
Clinical usefulness of non-protein respiratory quotient measurement in non-alcoholic fatty liver disease
复制标题
非蛋白质呼吸商测量在非酒精性脂肪肝中的临床应用
DOI：
10.1111/hepr.12095
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Hino K.
中科院分区：
文献类型：
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作者：
Korenaga K1;Korenaga M;Teramoto F;Suzuki T;Nishina S;Sasaki K;Nakashima Y;Tomiyama Y;Yoshioka N;Hara Y;Moriya T;Hino K.
关于非酒精性脂肪性肝病（NAFLD）对能量代谢的影响知之甚少，尽管这种疾病与代谢综合征有关。我们测量非蛋白质呼吸商（npRQ）使用间接量热法，这反映了葡萄糖氧化，并将此值与NAFLD patients.MethodsSubjects组织病理学诊断为NAFLD的32例患者的组织疾病严重程度进行了比较。受试者进行身体成分分析和间接热量测定，并计算npRQ。口服葡萄糖耐量试验进行，血浆葡萄糖曲线下面积（AUC葡萄糖）calculated.ResultsThere是没有差异的体重指数，体脂百分比或内脏脂肪面积纤维化阶段组之间。随着纤维化进展，npRQ显著降低（0期，0.895 ± 0.068; 1期，0.869 ± 0.067; 2期，0.808 ± 0.046; 3期，0.798 ± 0.026;P< 0.005）。随着纤维化分期的增加，葡萄糖耐受不良加重，胰岛素抵抗增加。npRQ与AUC葡萄糖呈负相关（R=-0.6308，P < 0.001），稳态评估模型-胰岛素抵抗（R=-0.5045，P < 0.005），空腹血糖（R=-0.4585，P < 0.01）和胰岛素水平（R=-0.4431，P < 0.05），提示npRQ降低可能反映了胰岛素抵抗导致的糖耐量受损，而胰岛素抵抗与纤维化进展相关。使用npRQ的纤维化阶段的估计是准确的几个以前建立的评分系统，使用receiver-operator curve analysis.ConclusionnpRQ显着降低晚期NAFLD患者。我们的数据表明，npRQ的测量是有用的估计NAFLD患者的疾病严重程度。
AimLittle is known about the effects of non‐alcoholic fatty liver disease (NAFLD) on energy metabolism, although this disease is associated with metabolic syndrome. We measured non‐protein respiratory quotient (npRQ) using indirect calorimetry, which reflects glucose oxidation, and compared this value with histological disease severity in NAFLD patients.MethodsSubjects were 32 patients who were diagnosed with NAFLD histopathologically. Subjects underwent body composition analysis and indirect calorimetry, and npRQ was calculated. An oral glucose tolerance test was performed, and plasma glucose area under the curve (AUC glucose) was calculated.ResultsThere were no differences in body mass index, body fat percentage or visceral fat area among fibrosis stage groups. As fibrosis progressed, npRQ significantly decreased (stage 0, 0.895 ± 0.068; stage 1, 0.869 ± 0.067; stage 2, 0.808 ± 0.046; stage 3, 0.798 ± 0.026;P< 0.005). Glucose intolerance worsened and insulin resistance increased with fibrosis stage. npRQ was negatively correlated with AUC glucose (R= −0.6308,P< 0.001), Homeostasis Model of Assessment – Insulin Resistance (R= −0.5045,P< 0.005), fasting glucose (R= −0.4585,P< 0.01) and insulin levels (R= −0.4431,P< 0.05), suggesting that decreased npRQ may reflect impaired glucose tolerance due to insulin resistance, which was associated with fibrosis progression. Estimation of fibrosis stage using npRQ was as accurate as several previously established scoring systems using receiver–operator curve analysis.ConclusionnpRQ was significantly decreased in patients with advanced NAFLD. Our data suggest that measurement of npRQ is useful for the estimation of disease severity in NAFLD patients.