瘦素和脂联素在非酒精性脂肪性肝病合并冠心病患者血清中的表达及意义

徐振; 刘守胜; 谭杰; 孙宝凯; 杜水仙; 辛永宁; 宣世英

doi:10.3969/j.issn.1001-5256.2020.11.016

瘦素和脂联素在非酒精性脂肪性肝病合并冠心病患者血清中的表达及意义

DOI: 10.3969/j.issn.1001-5256.2020.11.016

1. 潍坊医学院
2. 青岛市市立医院感染性疾病科
3. 青岛市市立医院中心实验室
4. 青岛市消化疾病重点实验室

基金项目:

国家自然科学基金面上项目（31770837）；

详细信息

中图分类号: R575.5;R541.4
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- 被引次数: 9
出版历程
- 收稿日期: 2020-05-12
- 出版日期: 2020-11-20

Expression and significance of leptin and adiponectin in serum of patients with nonalcoholic fatty liver disease and coronary heart disease

Weifang Medical University
Department of Infectious Diseases,Qingdao Municipal Hospital
Central Laboratory,Qingdao Municipal Hospital
Qingdao Key Laboratory of Digestive Diseases

Research funding:

摘要

摘要:
目的测定瘦素（LEP）和脂联素（ADPN）在非酒精性脂肪性肝病（NAFLD）合并冠心病（CHD）患者血清中的水平,探讨LEP、ADPN与NAFLD、CHD的相关性。方法纳入2018年10月-2019年8月就诊于青岛市市立医院的83例NAFLD患者（NAFLD组）,86例NAFLD合并CHD患者（合并CHD组）及69例健康体检者（健康对照组）。收集受试者的临床资料和血液标本,应用酶联免疫吸附法（ELISA）测定受试者血清中LEP及ADPN的水平,应用全自动生化分析仪检测肝功能。符合正态分布的计量资料3组间比较采用方差分析,进一步两两比较采用LSD-t检验;不符合正态分布的计量资料3组间比较采用Kruskal-Wallis H检验。计数资料组间比较采用χ2检验。LEP、ADPN及其他相关指标与NAFLD和NAFLD合并CHD的关系分析采用logistic回归分析; LEP及ADPN与其他各指标的相关性分析采用Pearson相关分析法。结果 NAFLD组血清中LEP的水平显著高于健康对照组（P<0.05）,ADPN的水平显著低于健康对照组（P <0.05）...
- 非酒精性脂肪性肝病 /
- 冠心病 /
- 瘦素 /
- 脂联素
Abstract:
Objective To investigate the expression of leptin( LEP) and adiponectin( ADPN) in the serum of patients with nonalcoholic fatty liver disease( NAFLD) and coronary heart disease( CHD) and the association of LEP and ADPN with NAFLD and CHD. Methods A total of 83 patients with NAFLD,86 patients with NAFLD and CHD,and 69 healthy individuals,who attended Qingdao Municipal Hospital from October 2018 to August 2019,were enrolled as NAFLD group,NAFLD + CHD group,and healthy control group,respectively.Clinical data and blood samples were collected; ELISA was used to measure the serum levels of LEP and ADPN,and an automatic biochemical analyzer was used to investigate liver function. An analysis of variance was used for comparison of normally distributed continuous data between three groups,and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between three groups. The chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used to investigate the association of LEP,ADPN,and other related indices with NAFLD or NAFLD with CHD,and a Pearson correlation analysis was used to investigate the correlation of LEP and ADPN with other indices. Results The NAFLD group had a significantly higher serum level of LEP and a significantly lower serum level of ADPN than the healthy control group( both P < 0. 05); the NAFLD + CHD group had a significantly higher serum level of LEP and a significantly lower serum level of ADPN than the NAFLD group( both P < 0. 05); the NAFLD + CHD group had a significantly higher serum level of LEP and a significantly lower serum level of ADPN than the healthy control group( both P < 0. 05). Body mass index( BMI)( odds ratio [OR]=23. 564,95% confidence interval [CI]: 2. 696-205. 919,P < 0. 05),fasting blood glucose( OR = 5. 559,95% CI: 1. 030-29. 996,P < 0. 05),triglyceride( OR = 7. 740,95% CI: 1. 379-43. 426,P < 0. 05),high-density lipoprotein( OR = 0. 072,95% CI: 0. 019-0. 268,P < 0. 05),LEP( OR = 17. 549,95% CI: 2. 344-131. 357,P < 0. 05),and ADPN( OR = 0. 182,95% CI: 0. 043-0. 760,P < 0. 05) were all associated with the risk of NAFLD,and BMI( OR = 11. 561,95% CI: 4. 828-27. 682,P < 0. 05),LEP( OR =19. 804,95% CI: 2. 476-158. 402,P < 0. 05),and ADPN( OR = 0. 025,95% CI: 0. 005-0. 121,P < 0. 05) were all associated with the risk of CHD. In the NAFLD group,the serum level of ADPN was positively correlated with low-density lipoprotein( r = 0. 251,P =0. 022),and in the NAFLD + CHD group,the serum level of LEP was positively correlated with BMI( r = 0. 241,P = 0. 025). Conclusion Hypoadiponectinemia and hyperleptinemia are not only the risk factors for NAFLD,but they may also increase the risk of CHD in NAFLD patients,and BMI is the basis for the association between the abnormal expression of leptin and the risk of CHD in NAFLD.
- non-alcoholic fatty liver disease /
- coronary disease /
- leptin /
- adiponectin

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参考文献(33)

[1] RINELLA ME. Nonalcoholic fatty liver disease:A systematic review[J]. JAMA,2015,313(22):2263-2273.

[2] LI J,ZOU B,YEO YH,et al. Prevalence,incidence,and outcome of non-alcoholic fatty liver disease in Asia,1999-2019:A systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol,2019,4(5):389-398.

[3] SOOKOIAN S,PIROLA CJ. Genetics of nonalcoholic fatty liver disease:From pathogenesis to therapeutics[J]. Semin Liver Dis,2019,39(2):124-140.

[4] POLYZOS SA,KOUNTOURAS J,MANTZOROS CS. Adipokines in nonalcoholic fatty liver disease[J]. Metabolism,2016,65(8):1062-1079.

[5] KOLODZIEJCZYK AA,ZHENG D,SHIBOLET O,et al. The role of the microbiome in NAFLD and NASH[J]. EMBO Mol Med,2019,11(2):e9302.

[6] ONG JP,PITTS A,YOUNOSSI ZM. Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease[J]. J Hepatol,2008,49(4):608-612.

[7] ISMAIEL A,DUMITRASCU DL. Cardiovascular risk in fatty liver disease:The liver-heart axis-literature review[J]. Front Med(Lausanne),2019,6:202.

[8] BROUWERS M,SIMONS N,STEHOUWER C,et al. Non-alcoholic fatty liver disease and cardiovascular disease:Assessing the evidence for causality[J]. Diabetologia,2020,63(2):253-260.

[9] MANTZOROS CS,MAGKOS F,BRINKOETTER M,et al. Leptin in human physiology and pathophysiology[J]. Am J Physiol Endocrinol Metab,2011,301(4):e567-e584.

[10] LEYVA F,GODSLAND IF,GHATEI M,et al. Hyperleptinemia as a component of a metabolic syndrome of cardiovascular risk[J]. Arterioscler Thromb Vasc Biol,1998,18(6):928-933.

[11] BULLOM,GARCíA-LORDA P,MEGIAS I,et al. Systemic inflammation,adipose tissue tumor necrosis factor,and leptin expression[J]. Obes Res,2003,11(4):525-531.

[12] YANG H,GUO W,LI J,et al. Leptin concentration and risk of coronary heart disease and stroke:A systematic review and meta-analysis[J]. PLo S One,2017,12(3):e0166360.

[13] MOSCHEN AR,WIESER V,TILG H. Adiponectin:Key player in the adipose tissue-liver crosstalk[J]. Curr Med Chem,2012,19(32):5467-5473.

[14] TILG H,MOSCHEN AR. Adipocytokines:Mediators linking adipose tissue,inflammation and immunity[J]. Nat Rev Immunol,2006,6(10):772-783.

[15] QIU Y,WANG SF,YU C,et al. Association of circulating adipsin,visfatin,and adiponectin with nonalcoholic fatty liver disease in adults:A case-control study[J]. Ann Nutr Metab,2019,74(1):44-52.

[16] ZHANG H,NIU Y,GU H,et al. Low serum adiponectin is a predictor of progressing to nonalcoholic fatty liver disease[J].J Clin Lab Anal,2019,33(3):e22709.

[17] BORGES MC,LAWLOR DA,de OLIVEIRA C,et al. Role of adiponectin in coronary heart disease risk:A mendelian randomization study[J]. Circ Res,2016,119(3):491-499.

[18] AU YEUNG SL,SCHOOLING CM. Adiponectin and coronary artery disease risk:A bi-directional Mendelian randomization study[J]. Int J Cardiol,2018,268:222-226.

[19] OBATA Y,YAMADA Y,KYO M,et al. Serum adiponectin levels predict the risk of coronary heart disease in Japanese patients with type 2 diabetes[J]. J Diabetes Investig,2013,4(5):475-482.

[20] National Workshop on Fatty Liver and Alcoholic Liver Disease,Chinese Society of Hepatology,Chinese Medical Association;Fatty Liver Expert Committee,Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease:A 2018 update[J]. J Clin Hepatol,2018,34(5):947-957.(in Chinese)中华医学会肝病学分会脂肪肝和酒精性肝病学组，中国医师协会脂肪性肝病专家委员会．非酒精性脂肪性肝病防治指南(2018更新版)[J]．临床肝胆病杂志，2018,35(5):947-957.

[21] RATZIU V,BELLENTANI S,CORTEZ-PINTO H,et al. A position statement on NAFLD/NASH based on the EASL 2009special conference[J]. J Hepatol,2010,53(2):372-384.

[22] MARCHESINI G,BUGIANESI E,FORLANI G,et al. Nonalcoholic fatty liver,steatohepatitis,and the metabolic syndrome[J]. Hepatology,2003,37(4):917-923.

[23] TSOCHATZIS EA,PAPATHEODORIDIS GV,ARCHIMANDRITIS AJ. Adipokines in nonalcoholic steatohepatitis:From pathogenesis to implications in diagnosis and therapy[J]. Mediators Inflamm,2009,2009:831670.

[24] ROTUNDO L,PERSAUD A,FEURDEAN M,et al. The Association of leptin with severity of non-alcoholic fatty liver disease:A population-based study[J]. Clin Mol Hepatol,2018,24(4):392-401.

[25] KARAKAS M,ZIERER A,HERDER C,et al. Leptin,adiponectin,their ratio and risk of coronary heart disease:Results from the MONICA/KORA augsburg study 1984-2002[J].Atherosclerosis,2010,209(1):220-225.

[26] ZENG R,XU CH,XU YN,et al. Association of leptin levels with pathogenetic risk of coronary heart disease and stroke:A meta-analysis[J]. Arq Bras Endocrinol Metabol,2014,58(8):817-823.

[27] SATTAR N,WANNAMETHEE G,SARWAR N,et al. Leptin and coronary heart disease:Prospective study and systematic review[J]. J Am Coll Cardiol,2009,53(2):167-175.

[28] BALMER ML,JONELI J,SCHOEPFER A,et al. Significance of serum adiponectin levels in patients with chronic liver disease[J]. Clin Sci(Lond),2010,119(10):431-436.

[29] ADOLPH TE,GRANDER C,GRABHERR F,et al. Adipokines and non-alcoholic fatty liver disease:Multiple Interactions[J]. Int J Mol Sci,2017,18(8):1649.

[30] PAGANO C,SOARDO G,ESPOSITO W,et al. Plasma adiponectin is decreased in nonalcoholic fatty liver disease[J].Eur J Endocrinol,2005,152(1):113-118.

[31] TURER AT,SCHERER PE. Adiponectin:Just along for the ride?[J]. Circ Res,2016,119(3):407-408.

[32] HUI XY,LAM KSL,VANHOUTTE PM,et al. Adiponectin and cardiovascular health:An update[J]. Review Br J Pharmacol,2012,165(3):574-590.

[33] SOOK LEE E,PARK SS,KIM E,et al. Association between adiponectin levels and coronary heart disease and mortality:A systematic review and meta-analysis[J]. Int J Epidemiol,2013,42(4):1029-1039.

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