Adipocyte cell size, free fatty acids and apolipoproteins are associated with non-alcoholic liver injury progression in severely obese patients
Adipocyte cell size, free fatty acids and apolipoproteins are associated with non-alcoholic liver injury progression in severely obese patients
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DOI：
10.1016/j.metabol.2014.09.001
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发表时间：
2014-12-01
影响因子：
9.8
通讯作者：
Canbay, Ali
中科院分区：
文献类型：
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作者：
Wree, Alexander;Schlattjan, Martin;Canbay, Ali
目的。肥胖是一种不断扩大的现代流行病，是非酒精性脂肪性肝病(NAFLD)的独立危险因素，非酒精性脂肪性肝病是西化国家最常见的肝病。脂肪组织和肝脏之间的串扰是NAFLD发展的关键。因此，在一项观察性研究中，93名严重肥胖患者在减肥手术时平均年龄43岁，平均BMI为52 kg/m(2)，采集了血液、内脏脂肪组织和肝组织。在一组患者中，在手术后6周获得随访血样，以评估体重减轻的急性影响。除了常规的肝损伤参数外，还分析了血清样本中的瘦素、脂联素、游离脂肪酸(FFAs)和几种载脂蛋白。主要发现。内脏脂肪细胞直径与肝损伤、血清炎症标志物和血清脂肪因子水平相关。血清学(ALT、AST)和组织学(NAFLD活动评分，NAS)评估的肝损伤与BMI无关。然而，血清甘油三酯和载脂蛋白CIII水平与NAS相关。血清FFAs水平和组成，尤其是长链FFAs与NAS密切相关。术后6周的血清样本分析显示，血清甘油三酯、载脂蛋白III和几种FFA水平发生了有益的变化。在严重肥胖的患者中，早在减肥手术后六周就可以观察到对肝脏损伤的有益影响。这些影响可能是通过观察到的脂肪组织和脂肪代谢的变化来解释的。总而言之，这些发现强调了脂肪组织和肝脏之间联系的重要性。(C)2014 Elsevier Inc.保留所有权利。
Purpose. Obesity is a modern pandemic with continuous expansion and represents an independent risk factor for non-alcoholic fatty liver disease (NAFLD), the most common liver disease in westernized countries. The crosstalk between adipose tissue and the liver is key to the development of NAFLD.Procedures. Therefore, in an observational study blood, visceral adipose tissue and liver tissue were obtained from 93 severely obese patients with a mean age of 43 years and mean BMI of 52 kg/m(2) at the time of weight loss surgery. In a subset of patients a follow-up blood sample was obtained 6 weeks after surgery to assess acute effects of weight loss. In addition to routine parameters of liver injury, serum samples were analyzed for leptin, adiponectin, free fatty acids (FFAs), and several apolipoproteins.Main findings. The diameter of visceral adipocytes correlated to liver injury, serum markers of inflammation and serum adipokine levels. Liver injury assessed by serology (ALT, AST) and histology (NAFLD activity score, NAS) was independent of the BMI. However, serum levels of triglycerides and Apolipoprotein CIII (ApoCIII) were associated with NAS. Serum levels and composition of FFAs, especially long chain FFAs, also correlated with NAS. Analysis of serum samples six weeks after surgery revealed beneficial changes in serum triglycerides, levels of ApoCIII and several FFAs.Conclusions. In severely obese patients beneficial effects on liver injury can been observed as early as six weeks after bariatric surgery. These effects may be explained by the observed changes in adipose tissue and lipid metabolism. Collectively, these findings underline the importance of the link between adipose tissue and the liver. (C) 2014 Elsevier Inc. All rights reserved.