非酒精性脂肪肝患者血清TNF-α、IL-6水平及意义

Study of the relationship between serum tumor necrosis factor-alpha, interleukin-6 and non-alcoholic fatty liver

目的探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平与非酒精性脂肪肝(NAFL)及胰岛素抵抗的关系。方法选择脂肪肝患者276人(脂肪肝组)和健康对照186人(正常对照组),抽取空腹静脉血检测血脂、胰岛素、血糖及血清TNF-α、IL-6水平,计算BMI、HOMA-IR,分析TNF-α、IL-6与NAFL及上述指标的关系。结果校正性别、年龄、吸烟、BMI、SBP、DBP、TC、HDL-c、LDL-c、TG及HOMA-IR等影响因素后,脂肪肝组血清TNF-α、IL-6及HOMA-IR水平较正常组升高(P=0.000,P=0.000,P=0.029);Logistic回归分析结果提示在校正性别、年龄、吸烟、BMI、SBP、DBP、HOMA-IR、TC、HDL-c、LDL-c、TG等影响因素后,分别以血清TNF-α、IL-6三分位最低层为对照,在血清TNF-α第二、三分位层时患脂肪肝的OR值分别为1.660(P=0.049)、4.604(P=0.000),在血清IL-6第二、三分位层时患脂肪肝的OR值分别为4.581(P=0.000)、4.842(P=0.000);偏相关分析提示:校正了年龄、性别、SBP、DBP、TG、TC、HDL-c、LDL-c后,HOMA-IR与血清TNF-α、IL-6水平正相关(r=0.567,P=0.000;r=0.622,P=0.000)。结论 TNF-α、IL-6水平升高是NAFL的独立危险因素,血清TNF-α、IL-6增高与NAFL患者胰岛素抵抗密切相关。

【Objective】To investigate the relationship among serum tumor necrosis factor-alpha（TNF-α）, Inter- leukin-6（IL-6）, insulin resistance and Non-Alcoholic Fatty Liver（NAFL）.【Methods】We recruited 276 patients with NAFL（case group） and 186 healthy controls（control group）. Fasting blood were obtained from all subjects. Then we measured the serum lipids, insulin, blood glucose, TNF-α and IL-6 levels in all subjects and also calcu- lated BMI, HOMA-IR. We analyzed the relationship among TNF-α, IL-6, NAFL and all above-mentioned profiles finally. 【Results】After adjusting of sex, age, smoking, BMI, SBP, DBP, TC, HDL-c, LDL-c, TG and HOMA-IR, compared with the normal group, the a serum TNF-α, IL-6 level and HOMA-IR in NAFL group was increased and has significant difference（P =0.000, P =0.000, P =0.029）. The results of logistic regression analysis suggest that after adjusting of sex, age, smoking, BMI, SBP, DBP, HOMA-IR, TC, HDL-c, LDL-c and TG, compared with the lowest TNF-α, IL-6 levels group, the OR value of NAFL of the second, third group were 1.660（P =0.049） and 4.604（P = 0.000） for TNF-α, then 4.581（P =0.000） and 4.842（P =0.000） for IL-6, respectively. After adjusted age, sex, smoking, BMI, SBP, DBP, TG, TC, HDL-c, LDL-c, partial correlation analysis suggests that HOMA-IR was positive correlation to serum TNF-α and IL-6 level（r =0.567, P =0.000; r =0.622, P =0.000）, respectively.【Conclusions】 The higher serum TNF-α, IL-6 level was independent risk factors for NAFL. Serum TNF-α, IL-6 was positive cor- relation to insulin resistance in NAFL patients.