非酒精性脂肪性肝病患者的炎症细胞因子 水平与氧化应激参数的变化

Changes of inflammatory cytokines and oxidative stress-related parameters in patients with nonalcoholic fatty liver disease

关键词:  非酒精性脂肪性肝病  炎症细胞因子  氧化应激参数  代谢综合征

Key words:  nonalcoholic fatty liver disease  inflammatory cytokine  oxidative stress-related parameter  metabolic syndrome

摘要:

目的观察非酒精性脂肪性肝病（nonalcoholic fatty liver disease, NAFLD)患者血清炎症细胞因子水平与 氧化应激参数的变化。方法检测182例新诊断的NAFLD患者和50例健康个体的血清TNF-ouILA、丙二醛 (malondialdehyde, MDA)、超氧化物歧化酶（superoxide dismutase, SOD)及相关生化指标，肝/脾CT比值，用稳态 模型评估暖岛素抵抗指数（homeostasis model assessment of insulin resistance, HOMA-IR)。结果与健康对照组比 较，NAFLD 患者血清 TNF-α、IL-6、MDA、餐后 2 h 血糖（2 h postprandial blood glucose, 2hBG)、空腹肢岛素（fasting insulin,只奶）、餐后2 11胰岛素（2111阳）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C)、三酰甘油（TG、尿酸 (UA)、游离脂肪酸（FFA)、超敏C反应蛋白（hsCRP)、丙氨酸转氨酶（ALT)、天冬氨酸氨基转移酶（AST)、γ-谷氨 酰转肽酶（GGT)以及体质量指数（BMI)、HOMA-IR均明显升高（均<P<0.05),而血清SOD和肝/脾CT比值明显 降低（均P<0.01)。NAFLD组患者血清TNF-α和IL-6水平均与HOMA-IR、FFA、TG、BMI、2hINS呈正相关（P<0.05),而血清MDA水平与ALT、AST呈正相关（P<0.01)，血清SOD水平则与ALT呈负相关（P<0.01)。结论NAFLD患者的炎症细胞因子水平与氧化应激参数明显升高，合并更多的代谢指标异常。

Abstract:

Objective To investigate the changes of inflammatory cytokines and oxidative stress-related parameters in patients with nonalcoholic fatty liver disease (NAFLD). Methods One hundred and eighty-two newly-diagnosed NAFLD patients and 50 healthy subjects ( control group) were enrolled in the study. Serum tumor necrosis factor-a ( TNF-α ), interleukin-6 ( EL-6 )，malondialdehyde (MDA)，superoxide dismutase (SOD)and other relative biochemical indicators were measured. CT value ratio (liver and spleen) and homeostasis model assessment of insulin resistance (HOMA-IR) were also determined. Results Levels of serum TNF-a, IL-6, MDA, 2-h postprandial blood glucose (2hBG)，fasting insulin (FINS)，2-h postprandial insulin (2hINS)，total cholesterol (TC)，low density lipoprotein cholesterol (LDL-C)，triacylglyceride (TG)，uric acid (UA)，free fatty acids ( FFA)，high sensitive C-reactive protein (hsCRP), alanine aminotransferase ( ALT)， aspartate aminotransferase (AST)，gamma-glutamyl transferase (GGT)，body mass index (BMI)and HOMA-IR were significantly higher, SOD and CT value ratio (liver and spleen) were significantly lower in NAFLD group than those in control group (P<0.05). In the NAFLD patients,TNF-α and IL-6 were positively correlated with HOMA-IR, FFA, TG, BMI and 2hINS (P<0.05), MDA was positively correlated with ALT and AST (P<0.01), SOD was negatively correlated with ALT (P<0.01). Conclusion There are higher levels of inflammatory cytokines and oxidative stress-related parameters and more abnormal metabolic indexes in NAFLD patients than those in healthy individuals.