脂肪因子Chemerin在非酒精性脂肪肝中的临床意义

Clinical significance of chemerin in Nonalcoholic fatty liver disease

目的探讨非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)患者血清chemerin水平的变化及临床意义。方法选择2010年5月—2011年6月NAFLD患者46例,轻度24例B组,中重度22例C组,正常对照组26例A组,分别检测各组空腹血糖(FBS)、胰岛素(FINS)、血脂、chemerin水平及体质指标。甘油三酯、空腹胰岛素、HOMA-IR、chemerin均经对数(lg10)转换使之正态化后再分析。采用方差分析、相关分析、偏相关分析以及多元线性回归分析,P<0.05为差异有统计学意义。结果三组中的收缩压、舒张压均无明显差异(均P>0.05)。NAFLD组(B+C组)WC、WHR、BMI、FBS、FINS、HOMA-IR、TG、TC、LDL-C、Chemerin水平均显著高于正常对照组(均P<0.05);HDL-C水平显著低于正常对照组(P<0.05);而中重度NAFLD组(C组)BMI、FINS、TG、HOMA-IR、Chemerin水平均显著高于轻度NAFLD组(均P<0.05)。应用Pearson相关性分析显示,血清Chemerin水平与BMI(r=0.482)、WHR(r=0.421)、TG(r=0.390)、HOMA-IR(r=0.329)、FINS(r=0.301)、TC(r=0.287)LDL-C(r=0.253)正相关,与HDL-C(r=-0.316)负相关(P<0.05)。以是否患NAFLD为应变量,以WC、WHR、BMI、FBS、FINS、HOMA-IR、TG、TC、LDL-C、Chemerin为自变量,进行逐步回归分析。结果显示TG、Chemerin、进入方程,Y=31.533+1.372*TG+0.864*Chemerin。结论 NAFLD患者中血清Chemerin水平增加,在NAFLD的发生发展中具有重要的意义。

Objective To discuss the serum level of chemerin in nonalcoholic fatty liver disease（NAFLD）and its clinical significance.Methods From May 2010 until June 2011,46 patients with NAFLD were selected and divided into mild group（n=24）,moderate to severe group（n=22）and control group（n=26）.All patients were tested for FBS,FINS,blood lipids,chemerin levels,and body mass index.After logarithm transformation,triglycerides,fasting insulin,HOMA-IR and chemerin（LG10） were in normalization and were analyzed afterwards.Analysis of variance,correlation analysis,partial correlation analysis and multiple linear regression analysis were used,the result of P〈0.05 was considered statistically significant.Results No significant difference was found in systolic blood pressure and diastolic blood pressure among three groups（all P〈0.05）.Compared with control group,the parameter levels of NAFLD group such as WC,WHR,BMI,FBS,FINS,HOMA-IR,TG,TC,LDL-C and chemerin were markedly higher（P〈0.05）;HDL-C levels were significantly lower（P〈0.05）.The levels of BMI,FINS,TG,HOMA-IR and chemerin were significantly higher in moderate to severe group than in mid group（P〈0.05）.Pearson relation analysis showed that chemerin levels were positively correlated with BMI,WHR,TG,HOMA-IR,FINS,TC,LDL-C and LDL-C,and negatively correlated with HDL-C（P〈0.05）.Stepwise regression analysis was carried out on the basis that suffering from NAFLD served as a dependent variable,while WC,WHR,BMI,FBS,FINS,HOMA-IR,TG,TC,LDL-C and Chemerin as independent variables.Conclusions Chemerin levels increase obviously in patients with NAFLD,which is of great significance to the development of NAFLD.