脂肪变性
维加维斯
内科学
非酒精性脂肪肝
胃肠病学
医学
胰岛素抵抗
视黄醇结合蛋白
丙型肝炎病毒
脂肪肝
体质指数
肝病学
肝活检
内分泌学
活检
免疫学
肥胖
疾病
视黄醇
病毒
脂肪因子
维生素
作者
Salvatore Petta,Calogero Cammà,Giada Sebastiani,Nicola Alessi,F. Barbaria,Daniela Cabibi,Rosalia Caldarella,Stefania Ciminnisi,Anna Licata,Maria Fatima Massenti,Alessandra Mazzola,Giuseppe Tarantino,Giulio Marchesini,Antonio Craxı̀
出处
期刊:Hepatology
[Wiley]
日期:2008-07-01
卷期号:48 (1): 28-37
被引量:54
摘要
Retinol-binding protein 4 (RBP4) is an adipocytokine associated with insulin resistance (IR). We tested serum levels of RBP4 to assess its link with steatosis in patients with genotype 1 chronic hepatitis C (CHC) or nonalcoholic fatty liver disease (NAFLD). Nondiabetic patients with CHC (n = 143) or NAFLD (n = 37) were evaluated by liver biopsy and anthropometric and metabolic measurements, including IR by the homeostasis model assessment. Biopsies were scored by Scheuer classification for CHC, and Kleiner for NAFLD. Steatosis was tested as a continuous variable and graded as absent-mild <30%, or moderate-severe ≥30%. Thirty nondiabetic, nonobese blood donors served as controls. RBP4 levels were measured by a human competitive enzyme-linked immunosorbent assay kit (AdipoGen). Mean values of RBP4 were similar in NAFLD and CHC (35.3 ± 9.3 μg/L versus 36.8 ± 17.6; P = 0.47, respectively), and both were significantly higher than in controls (28.9 ± 12.1; P = 0.02 and P = 0.01, respectively). RBP4 was higher in CHC patients with steatosis than in NAFLD (42.1 ± 19.7 versus 35.2 ± 9.3; P = 0.04). By linear regression, RBP4 was independently linked to steatosis only (P = 0.008) in CHC, and to elevated body mass index (P = 0.01) and low grading (P = 0.04) in NAFLD. By linear regression, steatosis was independently linked to homeostasis model assessment score (P = 0.03) and high RBP4 (P = 0.003) in CHC. By logistic regression, RBP4 was the only variable independently associated with moderate-severe steatosis in CHC (odds ratio, 1.045; 95% confidence interval, 1.020 to 1.070; P = 0.0004), whereas waist circumference was associated with moderate-severe steatosis in NAFLD (odds ratio, 1.095; 95% confidence interval, 1.007 to 1.192; P = 0.03). Conclusion: In nondiabetic, nonobese patients with genotype 1 CHC, serum RBP4 levels might be the expression of a virus-linked pathway to steatosis, largely unrelated to IR. (HEPATOLOGY 2008.)
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