内脂素与非酒精性脂肪肝肝纤维化及胰岛素抵抗的关系

Association of serum vaspin with liver fibrosis of nonalcoholic fatty liver disease and insulin resistance

目的研究内脂素(vaspin)水平与非酒精性脂肪肝(NAFLD)患者肝纤维化指标及胰岛素抵抗指数(IRI)的关系。方法采用酶联免疫吸附检测(ELASA)法对NAFLD组和对照组的内脂素及Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(PCⅣ)、透明质酸(HA)、层黏连蛋白(LN)水平进行检测,采用稳态模型胰岛素抵抗指数(HOMA-IRI)评估胰岛素抵抗。结果NAFLD组内脂素显著低于对照组(0.76±0.45)g/L vs(1.31±0.82)g/L;肝纤维化指标PCⅢ、HA、PCⅣ、LN及HOMA-IRI显著高于对照组(136.42±36.32)μg/L vs(98.16±23.71)μg/L,(95.33±37.63)μg/Lvs(69.26±29.16)μg/L,(75.52±32.56)μg/L vs(57.64±16.21)μg/L,(127.27±31.53)μg/L vs(102.43±27.14)μg/L,3.19±1.23 vs 1.84±0.71(均P<0.05);HOMA-IRI与PCⅢ、PCⅣ、HA和LN呈显著正相关(均P<0.05),内脂素水平与WHR、BMI、FBG、TG、FINS、HOMA-IRI、PCⅢ、PCⅣ、HA和LN呈显著负相关(P<0.01或<0.05)。结论NAFLD患者血清内脂素水平降低,内脂素的表达在NAFLD患者肝纤维化与胰岛素抵抗进程中可能起抑制作用。

Objective To investigate the relationship of the scale of serum vaspin to liver fibrosis indexes of nonalcoholic fatty liver disease（NAFLD） and insulin resistance index（IRI）. Methods Enzyme linked immunosorbent assay（ELASA） was used to measure the serum levels of vaspin,type Ⅲ precollagen（PCⅢ ）,type Ⅳ collagen（PCⅣ）, hyaluronic acid（HA） and laminin（LN） between NAFLD group and control group. IRI was calculated with Homeostasis Model Assessment. Results The level of vaspin significantly decreased in NAFLD group compared with that of control group （0.76±0.45） g/L vs （1.31±0.82） g/L（ P 〈0.05） ,while HOMA-IRI and liver fibrosis indexes PCⅢ , HA,PC Ⅳ ,LN significantly increased in NAFLD group in contrast to those of control group, HOMA-IRI 3.19 ± 1.23 vs 1.84 ± 0.71,PCⅢ （136.42±36.32） μg/L vs （98.16±23.71） μg/L, HA （95.33±37.63） μg/L vs （69.26±29.16） μg/L, PCIV （75.52±32.56） μg/L vs （57.64±16.21） μg/L,LN （127.27±31.53） μg/L vs （102.43±27.14） μg/L（ P 0.05）. There was positive correlation between HOMA-IRI and serum PCⅢ ,PCⅣ, HA,LN levels（all P 〈0.05） ,while negative correlation was evident among vaspin level and W HR, BMI, FBG, TG, FINS, HOMA-IRI, PC Ⅲ, PC Ⅳ, H A and LN,compared with those control group（ P 〈0.01 or 〈0.05）. Conclusion The level of vaspin significantly decreases in NAFLD patients. The expression of vaspin may have significant negative influence on the process of liver fibrosis and insulin resistance in NAFLD patients.