Leptin, insulin resistance, and liver fibrosis in human nonalcoholic fatty liver disease
Leptin, insulin resistance, and liver fibrosis in human nonalcoholic fatty liver disease
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DOI：
10.1016/j.jhep.2004.08.020
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发表时间：
2004-12-01
影响因子：
25.7
通讯作者：
Jensen, MD
中科院分区：
文献类型：
--
作者：
Angulo, P;Alba, LM;Jensen, MD
背景/目标：来自纤维化和脂肪肝动物模型的数据表明，瘦素可能介导肝脏中的促纤维化反应，但瘦素与人类非酒精性脂肪性肝病（NAFLD）中的肝纤维化的关联仍不明确。我们旨在确定瘦素和肝纤维化在人类NAFLD.方法：人血浆瘦素和胰岛素抵抗的几个指标测定88例NAFLD患者和匹配的controls.Results：瘦素水平显着更高的患者与更先进的纤维化（P = 0.005）。通过多变量分析，当控制包括年龄、性别、BMI、糖尿病和胰岛素抵抗在内的混杂因素时，瘦素和纤维化之间的显著相关性被消除（校正P=0.3）。只有年龄（校正后P=0.006）和胰岛素敏感性（校正后P = 0.04）与纤维化分期显著相关。在27.9 ± 16个月时，88例患者中的39例进行了第二次肝活检。瘦素水平在纤维化进展患者（n = 10）和非纤维化进展患者（n = 29）之间没有显著差异。结论：在人类NAFLD中，瘦素水平与纤维化分期之间没有关系。瘦素和纤维化严重程度的相关性似乎是决定瘦素产生的因素的指标。(C)2004年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background/Aims: Data from animal models of fibrosis and fatty liver suggest that leptin may mediate the profibrogenic responses in the liver, but the association of leptin and liver fibrosis in human nonalcoholic fatty liver disease (NAFLD) remains undefined. We aimed at determining the relation between leptin and liver fibrosis in human NAFLD.Methods: Human plasma leptin and several indicators of insulin resistance were measured in 88 NAFLD patients and matched controls.Results: Leptin levels were significantly greater in patients with more advanced fibrosis (P = 0.005). By multivariate analysis, the significant association between leptin and fibrosis was abolished (adjusted P=0.3) when controlling for confounders including age, gender, BMI, diabetes and insulin resistance. Only age (adjusted P=0.006) and insulin sensitivity (adjusted P = 0.04) correlated significantly with fibrosis stage. A second liver biopsy was performed in 39 out of the 88 patients at 27.9 +/- 16 months. Leptin levels were not significantly different between patients who had fibrosis progression (n = 10) and those who did not (n = 29).Conclusions: In human NAFLD, no relationship between leptin levels and fibrosis stage was demonstrated. The correlation of leptin and fibrosis severity seems to be an indicator of the factors that determine leptin production. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.