Changed Amino Acids in NAFLD and Liver Fibrosis: A Large Cross-Sectional Study without Influence of Insulin Resistance
Changed Amino Acids in NAFLD and Liver Fibrosis: A Large Cross-Sectional Study without Influence of Insulin Resistance
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NAFLD和肝纤维化中氨基酸的改变：一项不影响胰岛素抵抗的大型横断面研究
DOI：
10.3390/nu12051450
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发表时间：
2020-05-01
期刊：
影响因子：
5.9
通讯作者：
Fukuda, Shinsaku
中科院分区：
文献类型：
--
作者：
Hasegawa, Takuma;Iino, Chikara;Fukuda, Shinsaku
在非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）中发现了氨基酸水平的改变。然而，目前尚不清楚这种变化是由于肝脏代谢改变还是胰岛素抵抗。本研究的目的是澄清氨基酸水平，脂肪肝和肝纤维化之间的联系，同时消除胰岛素抵抗的影响。使用瞬时弹性成像诊断NAFLD和肝纤维化，并将受试者分为三组：正常、NAFLD和肝纤维化。为了排除胰岛素抵抗的影响，使用胰岛素抵抗的稳态模型评估（HOMA-IR）对受试者进行匹配。比较各组血清氨基酸水平。在731例入组受试者中，251例和33例被诊断为NAFLD和肝纤维化。尽管各组间大多数氨基酸水平存在显著性差异，但在与HOMA-IR匹配后，除谷氨酸和甘氨酸外，其余氨基酸均消失。多因素Logistic回归分析显示，谷氨酸、甘氨酸和HOMA-IR是肝纤维化的独立危险因素。大多数氨基酸的血清水平的改变与胰岛素抵抗相关，而谷氨酸的增加和甘氨酸水平的降低不仅与胰岛素抵抗密切相关，而且与肝纤维化患者的肝脏代谢改变密切相关。
Altered amino acid levels have been found in nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). However, it is not clear whether this alteration is due to altered hepatic metabolism or insulin resistance. The aim of this study was to clarify the association among amino acid levels, fatty liver, and liver fibrosis while eliminating the influence of insulin resistance. NAFLD and liver fibrosis were diagnosed using transient elastography and subjects were divided into three groups: normal, NAFLD, and liver fibrosis. To exclude the influence of insulin resistance, the subjects were matched using the homeostasis model assessment of insulin resistance (HOMA-IR). The amino acid serum levels were compared among the groups. Of 731 enrolled subjects, 251 and 33 were diagnosed with NAFLD and liver fibrosis. Although significant differences were observed among the groups in the serum levels of most amino acids, all but those of glutamate and glycine disappeared after matching for HOMA-IR. The multivariate logistic regression revealed that glutamate, glycine, and HOMA-IR were independent risk factors for liver fibrosis. The altered serum levels of most amino acids were associated with insulin resistance, while the increase in glutamate and the decrease in glycine levels were strongly associated not only with insulin resistance, but also with altered liver metabolism in patients with liver fibrosis.