不同亚型脂联素与非酒精性脂肪性肝病的关系

目的:探究总脂联素(total adiponectin,total APN)和高分子量脂联素(high-molecular-weight adiponectin,HMW APN)与非酒精性脂肪性肝病(Nonalcoholic Fatty Liver Disease,NAFLD)的关系。方法:连续纳入50名男性健康男性及50名非酒精性脂肪性肝病男性患者,收集患者临床资料及其他临床生化数据,通过ELISA法检测总脂联素、支链氨基酸及可溶性晚期糖基化终末产物含量,Western blot法测定高分子量、中分子量和低分子量脂联素水平,进一步分析其相关性。结果:与对照组的健康受试者相比,NAFLD患者的总脂联素和三种不同形式的脂联素水平均显著降低。在NAFLD患者中,总脂联素与身高(R=-0.270, P=0.032)和羧甲基赖氨酸(R=-0.259, P=0.040)显著负相关;高分子量脂联素与空腹血糖(R=0.350, P=0.016)显著正相关,与丙氨酸氨基转移酶(R=-0.321, P=0.029)和天门冬氨酸氨基转移酶(R=-0.295, P=0.045)显著负相关。结论:总脂联素和三种不同形式的脂联素水平均与NAFLD呈显著负相关。     

PNPLA3在实验性非酒精性脂肪性肝病中的表达及其CpG岛甲基化状态的研究

目的:探讨PNPLA3在非酒精性脂肪性肝病中的表达水平及其Cp G岛甲基化状态,探讨PNPLA3在NAFLD发生、发展中的作用。方法:1.采用10μg/m L的油酸作用于人正常肝细胞株L02建立脂肪肝细胞模型,72 h后经油红O染色,观察正常组、脂肪肝模型组及给药组细胞内脂滴形成情况,并用荧光定量PCR检测PNPLA3在三组肝细胞中的表达情况。2.采用专用DNA提取试剂盒分别提取正常组、脂肪肝模型组、给药组细胞中DNA,经亚硫酸转化后行PCR扩增目的基因,并用焦磷酸测序方法检测不同组PNPLA3 Cp G岛中甲基化水平,探讨其在非酒精性脂肪肝中的作用。结果:1、脂肪肝模型组肝细胞PNPLA3 m RNA的表达高于正常组,经姜黄素给药后,其表达降低,差异均有统计学意义(P0.05)。2、在PNPLA3启动子区6个检测位点中,脂肪肝组位点2甲基化水平高于正常组,姜黄素给药后甲基化水平降低,差异均有统计学意义(P0.05),在其余各检测位点中甲基化水平无差异。结论:1、油红O染色后,脂肪肝模型组细胞内发现有大量红色脂滴积聚,而正常组基本上未见脂滴,姜黄素给药组脂滴较模型组减少,表明用10μg/m L的油酸诱导能成功建立体外肝细胞模型。2、PNPLA3 m RNA在肝细胞中高表达及其启动子区甲基化状态异常参与非酒精性脂肪肝发病。3、抑制肝脏PNPLA3活性或降低肝细胞PNPLA3 m RNA的表达水平可能是今后治疗非酒精性脂肪性肝病(NAFLD)的一个新的治疗方法。     

高脂饮食性非酒精性脂肪性肝病小鼠肝脏脂代谢相关基因的改变

目的:分析非酒精性脂肪性肝病(NAFLD)小鼠肝脏中脂代谢相关基因的表达变化。方法:12周龄成年雄性C57BL/J6小鼠,随机分为对照组及NAFLD组。对照组予以普通饲料,NAFLD组予以高脂饮食喂养8周。分别测定两组小鼠肝功能、血脂及肝脂的变化,苏木精-伊红(HE)及油红O染色后光学显微镜下观察肝脏的形态结构和脂肪变性情况,并用实时荧光定量PCR(qPCR)法检测肝脏脂代谢重要基因的变化。结果:与对照组比较,NAFLD组小鼠的血清总甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及肝脏TG、肝脏TC水平均显著升高(P0.05)。HE和油红O染色显示NAFLD组小鼠发生了显著的肝脏脂质沉积。此外,NAFLD组小鼠肝脏中脂肪酸转位酶(CD36)表达水平显著高于对照组,而硬脂酰辅酶A去饱和酶1(SCD1)、固醇调控元件结合蛋白(SREBP1c)表达水平在两组小鼠中无统计学差异。结论:高脂饮食诱导的脂肪肝中CD36表达上调,可能参与了NAFLD的发病机制。     

非酒精性脂肪性肝病与代谢综合征组分的相关性研究进展

非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)在全世界人群中发病率逐年上升,成为新的全球公共健康问题,已越来越引起临床关注。其发病以胰岛素抵抗为基础,与肥胖、血脂紊乱、原发性高血压、2型糖尿病等代谢综合征各组分密切相关。NAFLD可进展至肝硬化、肝衰竭甚至肝癌,伴有代谢综合征一种或多种组分可能加速疾病的进展。NAFLD初期是一种可逆性过程,充分了解影响其发生、发展的相关代谢危险因素并及时纠正,可能导致疾病的逆转或延缓其进程。本文就NAFLD与代谢综合征各组分的相关调查研究进行综述。     

非酒精性脂肪性肝病的发病机制及治疗进展

近年来,随着人们生活水平的提高,脂肪性肝病的发病率明显上升,且患病年龄趋于低龄化,已经成为严重危害我国人民健康的常见疾病,我国非酒精性脂肪性肝病的发病率明显高于酒精性脂肪性肝病。本文主要对NAFLD的发病机制及相关治疗进展做简要的综述。NAFLD的发病机制与胰岛素抵抗、氧化应激、代谢综合征、脂肪细胞因子的作用、内质网应激、及铁超载等多种因素有关。NAFLD的治疗可以从防治原发病或相关危险因素、基础治疗(行为或生活方式干预;调整饮食;运动疗法)、药物治疗以及手术治疗等方面进行。了解国际上NAFLD的发病机制以及相关治疗进展,对遏制非酒精性脂肪性肝病的发生、发展趋势有着十分重要的意义。     

新加越鞠丸对非酒精性脂肪肝大鼠血清脂联素及瘦素水平的影响

目的:观察新加越鞠丸对非酒精性脂肪肝大鼠血清脂联素及瘦素的影响.方法:3只健康雄性SD大鼠随机分为4组,每组9只.高脂高糖饲料喂养制备大鼠非酒精性脂肪肝模型.8W病理显示造模成功后,每组给予相应药物干预,连续4W.酶联免疫吸附(ELISA)法测定各组大鼠血清中脂联素(ADP)浓度及瘦素(LP)浓度,HE染色观察肝脏病理变化.结果:与正常对照组大鼠比较,模型对照组血清中ADP浓度明显降低(P＜0.05),LP明显升高(P＜0.05);与模型对照组大鼠比较,新加越鞠丸组血清中ADP浓度明显升高(P＜0.05),LP明显降低(P＜0.05);新加越鞠丸组大鼠较水林佳组,血清中ADP浓度显著升高(P＜0.05),LP有显著性差异(P＜0.05).结论:新加越鞠丸可通过升高血清脂联素水平,降低血清瘦素水平,减轻非酒精性脂肪肝的损伤.     

代谢正常肥胖个体发生非酒精性脂肪性肝病的相关性研究

目的:探讨代谢正常肥胖(Metabolically healthy obese,MHO)个体与非酒精性脂肪性肝病(Nonalcoholic fatty liver disease,NAFLD)发生的相关性。方法:选择2006年4月～2010年1月来湖南省人民医院体检中心体检人群共4076例,排除过量饮酒者、乙肝标志物阳性者及相关资料不全者共2830例纳入本研究。其中1367例在1～3年后再次体检。记录受检者身高、体重、血压、血脂、空腹血糖、腹部B超结果。NAFLD采用2010年中华医学会肝病学分会诊断标准中影像学诊断定义,行腹部B超检查进行诊断。结果:1.我院体检人群中MHO合并NAFLD者占51.34%,明显高于正常对照组(P=0.000),MHO组发生NAFLD的OR值为19.967(95%CI,12.646-31.533;P=0.000)。2.随访1～3年后,MHO中NAFLD发病率高于正常对照组(44.44%vs 7.02%,OR=10.600,95%CI,4.873-23.058;P=0.000)。结论:MHO个体合并NAFLD比例较正常对照者升高,MHO个体增加NAFLD患病风险。     

非酒精性脂肪性肝病与MTP关系的实验研究

目的：探讨非酒精性脂肪性肝病( Non-alcoholic fatty liver disease, NAFLD)与微粒体甘油三酯转运蛋白(microsomal triglyceridetransfer protein,MTP）的关系。方法：将雄性Wistar 大鼠60只随机分为正常对照组（A 组）、高脂组（B 组）和MTP 抑制剂组（C 组）,每组各20 只。B 组、C组给予高脂饲料喂养,8 周后确认非酒精性脂肪肝建模成功,C组大鼠给予混有特异性小肠MTP抑制 剂JTT-130 的高脂饲料喂养,B 组大鼠建模过程始终喂养高脂饲料,A 组大鼠喂养普通饲料。于第12周,分别测定大鼠血清甘油 三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-c)含量,以及 肝脏TC、TG、磷脂含量。同时测定肝脏中微粒体甘油三酯转运蛋白(MTP) 的活性与mRNA 表达量。结果：与正常对照组（A组）相 比,高脂组（B组）大鼠血清TC、TG、HDL-c 浓度和肝脏TC、TG含量明显提高（P＜0.05）,MTP 活性及mRNA 水平明显下调（P＜ 0.05）。与高脂组（B 组）比较,MTP 抑制剂组（C 组）大鼠血清TC、TG、HDL-c 浓度和肝脏TC、TG 含量明显下降（P＜0.05）,而 MTP 活性及mRNA 表达量比较无明显差别（P＞0.05）。结论：非酒精性脂肪性肝病存在MTP表达下调,特异性小肠MTP 抑制剂 JTT-130 可以有效抑制肠道对TG的转运,不影响肝脏TG分泌,并在降低高脂大鼠血浆TG和胆固醇水平的同时也降低肝脏TG 含量。     

肠道菌群影响非酒精性脂肪性肝病的机制及应对策略

非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的发病率逐年升高,已成为最常见的肝脏疾病之一。目前其发病机制未被完全阐明,尚无有效治疗药物。肠道菌群与人体共生,作为人体的“第二基因组”,其在消化、吸收及代谢中发挥重要作用。新近研究表明,肠道菌群已成为影响NAFLD发生、进展的重要因素,肠道菌群失调和肠肝轴紊乱与非酒精性单纯性脂肪肝(nonalcoholic fatty liver,NAFL)发展为非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)、肝纤维化和肝细胞癌(hepatocellular carcinoma,HCC)密切相关。因此,肠道微生态干预有望成为预防或治疗NAFLD的新手段。本综述主要探讨肠道菌群异常对NAFLD/NASH发病过程、机制的影响及干预措施。     

Genetic Variants in PNPLA3 and Risk of Non-Alcoholic Fatty Liver Disease in a Han Chinese Population

We investigated the possible association between genetic variants in the Patatin like phospholipase-3 (PNPLA3) gene and nonalcoholic fatty liver disease (NAFLD) in a Han Chinese population. We evaluated twelve tagging single-nucleotide polymorphisms (tSNPs) of the PNPLA3 gene in a frequency matched case–control study from Fuzhou city of China (553 cases, 553 controls). In the multivariate logistic regression analysis, the rs738409 GG or GC, and rs139051 TT genotypes were found to be associated with increased risk of NAFLD, and a significant trend of increased risk with increasing numbers of risk genotype was observed in the cumulative effect analysis of these single nucleotide polymorphisms. Furthermore, haplotype association analysis showed that, compared with the most common haplotype, the CAAGAATGCGTG and CGAAGGTGTCCG haplotypes conferred a statistically significant increased risk for NAFLD, while the CGGGAACCCGCG haplotype decreased the risk of NAFLD. Moreover, rs738409 C>G appeared to have a multiplicative joint effect with tea drinking (P<0.005) and an additive joint effect with obesity (Interaction contrast ratio (ICR) = 2.31, 95% CI: 0.7–8.86), hypertriglyceridemia (ICR = 3.07, 95% CI: 0.98–5.09) or hypertension (ICR = 1.74, 95% CI: 0.52–3.12). Our data suggests that PNPLA3 genetic polymorphisms might influence the susceptibility to NAFLD development independently or jointly in Han Chinese.     

A Sequence Variation (I148M) in PNPLA3 Associated with Nonalcoholic Fatty Liver Disease Disrupts Triglyceride Hydrolysis

Obesity and insulin resistance are associated with deposition of triglycerides in tissues other than adipose tissue. Previously, we showed that a missense mutation (I148M) in PNPLA3 (patatin-like phospholipase domain-containing 3 protein) is associated with increased hepatic triglyceride content in humans. Here we examined the effect of the I148M substitution on the enzymatic activity and cellular location of PNPLA3. Structural modeling predicted that the substitution of methionine for isoleucine at residue 148 would restrict access of substrate to the catalytic serine at residue 47. In vitro assays using recombinant PNPLA3 partially purified from Sf9 cells confirmed that the wild type enzyme hydrolyzes emulsified triglyceride and that the I148M substitution abolishes this activity. Expression of PNPLA3-I148M, but not wild type PNPLA3, in cultured hepatocytes or in the livers of mice increased cellular triglyceride content. Cell fractionation studies revealed that ∼90% of wild type PNPLA3 partitioned between membranes and lipid droplets; substitution of isoleucine for methionine at position 148 did not alter the subcellular distribution of the protein. These data are consistent with PNPLA3-I148M promoting triglyceride accumulation by limiting triglyceride hydrolysis.     

The PNPLA3 Ile148Met interacts with overweight and dietary intakes on fasting triglyceride levels

The Ile148Met (rs738409, G-allele) in the patatin-like phospholipase domain-containing protein 3 gene (PNPLA3) associates with liver fat content and may lead to loss-of-function (hydrolysis) or gain-of-function (CoA-dependent lysophosphatidic acid acyltransferase) defects. PNPLA3 is up-regulated by dietary carbohydrates, and interactions between rs738409 and carbohydrates, and sugar and ω6:ω3-polyunsaturated fatty acid (PUFA) ratio on hepatic fat accumulation have been reported. We examined interaction between rs738409 and overweight, and between rs738409 and dietary intakes (carbohydrates, sucrose and ω6:ω3-PUFA ratio), on fasting triglyceride levels. From the Malmo Diet and Cancer Study-Cardiovascular Cohort, 4,827 individuals without diabetes aged 58 ± 6 years, 2,346 with BMI ≤ 25 kg/m² and 2,478 with BMI > 25 kg/m², were included in cross-sectional analyses. Dietary data were collected by a modified diet history method. Overweight modified the association between rs738409 and fasting triglyceride levels (P_interaction = 0.003). G-allele associated with lower triglycerides only among overweight individuals (P = 0.01). Nominally, significant interaction on triglyceride levels was observed between rs738409 and sucrose among normal-weight individuals (P_interaction = 0.03). G-allele associated with lower triglycerides among overweight individuals in the lowest tertiles of carbohydrate and ω6:ω3-PUFA ratio (P = 0.04 and P = 0.001) and with higher triglycerides among normal-weight individuals in the highest tertile of sucrose (P = 0.001). We conclude that overweight and dietary sucrose may modify the association between rs738409 and fasting triglyceride levels.

Electronic supplementary material

The online version of this article (doi:10.1007/s12263-014-0388-4) contains supplementary material, which is available to authorized users.     

Association between the PNPLA3 I148M Polymorphism and Non-Alcoholic Fatty Liver Disease in the Uygur and Han Ethnic Groups of Northwestern China

Objective

Multiple common gene variants play a role in non-alcoholic fatty liver disease (NAFLD) susceptibility. Our goal was to investigate the association between variants polymorphisms and NAFLD in the Uygur and Han from Northwestern China.

Methods

Eight tag single nucleotide polymorphisms (tSNPs) previously reported to be associated with NAFLD were characterized in 396 NAFLD individuals and 399 controls. The association of variants with NAFLD in the Uygur and Han was assessed using the chi-squared (χ²) test in different gene models. Unconditional logistic regression analysis was performed to obtain the odds ratios (ORs) for risk of NAFLD and their 95% confidence intervals (CI), adjusted for confounding factors. Finally, stratified analysis was used to explore the potential gene-environment interactions on the risk of NAFLD.

Results

In a recessive model, we found a potential association between rs738409 and NAFLD in both ethnic groups: Chinese Han (OR = 1.84, 95% CI: 1.03–3.27, p = 0.036), Uygur (OR = 2.25, 95% CI: 1.23–4.09, p = 0.006). The multiple logistic regression revealed that PNPLA3 rs738409 GG genotype may increase the risk of NAFLD by adjusting some confounding factors: Han (OR = 5.22, 95% CI: 1.94–14.04, p = 0.001), Uygur (OR = 4.29, 95% CI: 1.60–11.48, p = 0.004). Stratified analysis found that rs738409 polymorphism appeared to have interaction with sex, smoking status in Uygur, and have interaction with sex, age, BMI stage, lifestyle in Han.

Conclusion

Our data suggest the PNPLA3 I148M polymorphism influences susceptibility to NAFLD in the Han and Uygur of Northwestern China.     

Molecular dynamics simulation of PNPLA3 I148M polymorphism reveals reduced substrate access to the catalytic cavity

A missense mutation I148M in PNPLA3 (patatin‐like phospholipase domain‐containing 3 protein) is significantly correlated with nonalcoholic fatty liver disease (NAFLD). To glean insights into mutation's effect on enzymatic activity, we performed molecular dynamics simulation and flexible docking studies. Our data show that the size of the substrate‐access entry site is significantly reduced in mutants, which limits the access of palmitic acid to the catalytic dyad. Besides, the binding free energy calculations suggest low affinity for substrate to mutant enzyme. The substrate‐bound system simulations reveal that the spatial arrangement of palmitic acid is distinct in wild‐type from that in mutant. The substrate recognition specificity is lost due to the loop where the I148M mutation was located. Our results provide strong evidence for the mechanism by which I148M affects the enzyme activity and suggest that mediating the dynamics may offer a potential avenue for NAFLD. Proteins 2013. © 2012 Wiley Periodicals, Inc.     

Expression and characterization of a PNPLA3 protein isoform (I148M) associated with nonalcoholic fatty liver disease

A genetic variant of PNPLA3 (patatin-like phospholipase domain-containing 3; PNPLA3-I148M), a serine protease of unknown function, is associated with accumulation of triacylglycerol (TAG) in the liver. To determine the biological substrates of PNPLA3 and the effect of the I148M substitution on enzymatic activity and substrate specificity, we purified and characterized recombinant human PNPLA3 and PNPLA3-I148M. Maximal hydrolytic activity of PNPLA3 was observed against the three major glycerolipids, TAG, diacylglycerol, and monoacylglycerol, with a strong preference for oleic acid as the acyl moiety. Substitution of methionine for isoleucine at position 148 markedly decreased the V(max) of the enzyme for glycerolipids but had only a modest effect on the K(m). Purified PNPLA3 also catalyzed the hydrolysis of oleoyl-CoA, but the V(max) was 100-fold lower for oleoyl-CoA than for triolein. The thioesterase activity required the catalytic serine but was only modestly decreased by the I148M substitution. The enzyme had little or no hydrolytic activity against the other lipid substrates tested, including phospholipids, cholesteryl ester, and retinyl esters. Neither the wild-type nor mutant enzyme catalyzed transfer of oleic acid from oleoyl-CoA to glycerophosphate, lysophosphatidic acid, or diacylglycerol, suggesting that the enzyme does not promote de novo TAG synthesis. Taken together, our results are consistent with the notion that PNPLA3 plays a role in the hydrolysis of glycerolipids and that the I148M substitution causes a loss of function, although we cannot exclude the possibility that the enzyme has additional substrates or activities.     

非酒精性脂肪肝病大鼠肝脏SOCS-3 的表达与吡格列酮干预研究

目的:探讨SOCS-3在非酒精性脂肪肝病(NAFLD)发病中的作用以及吡格列酮的干预作用。方法:29只雄性SD大鼠随机分为正常对照组(8只),高脂饮食组(21只)。饲养8周后,从高质饮食组随机抽取5只大鼠证实造模成功后,将该组余下的16只大鼠继续以高脂饲料喂养,并随机分为NAFLD对照组(8只);吡格列酮干预组(8只),予以吡格列酮3mg·kg-·1d-1灌胃。16周末,处死所有大鼠,检测血糖、血胰岛素、血脂、肝脏SOCS-3 mRNA和SREBP-1c mRNA表达及肝脏病理学。结果:与正常对照组相比,NAFLD组血糖、血胰岛素、血脂、肝脏脂肪变水平及肝组织SOCS-3 mRNA、SREBP1c mRNA表达显著上调。吡格列酮干预组SOCS-3 mRNA、SREBP-1c mRNA表达较NAFLD组下调,且血糖、血胰岛素、血脂、肝脏脂肪变水平下降。SOCS-3 mRNA表达水平与胰岛素抵抗指数、SREBP-1c mRNA表达水平、肝脂肪变成显著正相关。结论:SOCS-3可能通过胰岛素抵抗及上调肝组织SREBP-1c mRNA表达参与NAFLD发病,吡格列酮能抑制肝脏SOCS-3的表达,对NAFLD有一定治疗作用。