The inflammatory C-Reactive Protein is increased in both liver and adipose tissue in severely obese patients independently from metabolic syndrome, type 2 diabetes, and NASH
The inflammatory C-Reactive Protein is increased in both liver and adipose tissue in severely obese patients independently from metabolic syndrome, type 2 diabetes, and NASH
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DOI：
10.1111/j.1572-0241.2006.00724.x
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发表时间：
2006-08-01
影响因子：
9.8
通讯作者：
Gual, Philippe
中科院分区：
文献类型：
--
作者：
Anty, Rodolphe;Bekri, Soumeya;Gual, Philippe
目的：C-反应蛋白（CRP）是一种非特异性炎症标志物，在肥胖、代谢综合征（MS）和2型糖尿病中中度升高，已被提议作为非酒精性脂肪性肝炎（NASH）的替代标志物。它在NASH诊断中的临床有用性在没有或患有MS、糖尿病和NASH的严重肥胖患者中进行了评估，并且描述了肝脏和脂肪组织在CRP产生中的潜在作用。无NASH的重度肥胖患者研究了患有MS（无MS [N = 13]，患有MS [N = 11]，或患有MS和糖尿病[N = 7]）和NASH（无MS [N = 8]或患有MS [N = 7]）的患者。对于每个患者，在减肥手术期间收集肝脏和脂肪组织活检，并用于通过实时PCR确定CRP基因表达。白细胞介素-6（IL-6）和脂多糖在CRP表达中的作用也进行了评估，在化妆品abdominoplasty.RESULTS：血浆CRP水平升高严重肥胖患者独立于MS，糖尿病或NASH的存在或不存在。与对照组相比，肥胖患者的CRP基因表达不仅在肝脏而且在脂肪组织中也增加。在人脂肪组织中，CRP mRNA水平与IL-6 mRNA水平呈正相关，IL-6和脂多糖在体外可增强CRP的表达。结论：血浆CRP水平不能预测严重肥胖患者NASH的诊断。肝脏以及脂肪组织可以产生CRP，这是一个可能依赖于IL 6的过程。因此，这两种组织都可能导致肥胖患者血浆CRP水平升高。此外，大量的身体脂肪很可能产生循环CRP的重要部分，进一步限制了其在严重肥胖患者中评估NASH的临床有用性。
OBJECTIVE: C-Reactive Protein (CRP), a nonspecific marker of inflammation that is moderately elevated in obesity, metabolic syndrome (MS), and type 2 diabetes, has been proposed as a surrogate marker of nonalcoholic steatohepatitis (NASH). Its clinical usefulness in the diagnosis of NASH was evaluated in severely obese patients without or with MS, diabetes, and NASH and the potential roles of the liver and of the adipose tissue in CRP production were characterized.METHODS: Severely obese patients without NASH (without MS [N = 13], with MS [N = 11], or with MS and diabetes [N = 7]) and with NASH (without [N = 8] or with [N = 7] MS) were studied. For each patient, liver and adipose tissue biopsies were collected during a bariatric surgery and were used to determine the CRP gene expression by real-time PCR. The role of interleukin-6 (IL6) and lipopolysaccharide in CRP expression was also evaluated in subcutaneous adipose tissue obtained during cosmetic abdominoplasty.RESULTS: Plasma CRP levels were elevated in severely obese patients independently from the presence or absence of MS, diabetes, or NASH. CRP gene expression was not only increased in livers but also in adipose tissues of obese patients compared with controls subjects. In human adipose tissue, CRP mRNA levels were positively correlated with those of IL-6 and the CRP expression was enhanced in vitro by IL-6 and lipopolysaccharide.CONCLUSION: Plasma CRP levels are not predictive of the diagnosis of NASH in severely obese patients. The liver but also the adipose tissue can produce CRP, a process which could be dependent on IL6. Therefore, both tissues might contribute to the elevated plasma CRP levels found in obesity. In addition, the large amount of body fat may well produce an important part of the circulating CRP, further limiting its clinical usefulness in the evaluation of NASH in severely obese patients.