高脂饮食及运动对2型糖尿病大鼠脂联素、瘦素及血糖水平的影响

目的：观察高脂饮食及运动对糖尿病大鼠脂联素、瘦素及血糖水平的影响。方法：选取SD清洁大鼠80只,雌雄各半,随机分为5组（n=16）：空白对照组（A）,普通饮食组（B）,高脂饮食组（C）,普通饮食干预组（普通饮食+运动干预,D）,高脂饮食干预组（高脂饮食+运动干预,E）;除空白组外,其余四组均给予高糖高脂饲料喂养6周后,腹腔链脲佐菌素（30 mg/kg）制备2型糖尿病模型（T2DM）;大鼠建模后,空白组、普通饮食组及普通饮食干预组给予常规饲料,高脂组及高脂饮食干预组大鼠给予高脂饲料,普通饮食干预组及高脂饮食干预组给予运动干预,采用滚筒训练器进行运动,运动频率为每天1次,每周6次,持续6周。6周后测量大鼠脂联素、瘦素、血糖及相关生化指标。结果：除空白组外,其余四组大鼠实验后脂联素水平明显降低（P<0.05）、瘦素、血糖、糖化血红蛋白、甘油三酯明显升高（P<0.05）;高脂饮食组大鼠瘦素、血糖、糖化血红蛋白、甘油三酯水平明显高于高脂饮食干预组（P<0.01）;高脂饮食干预组大鼠瘦素、血糖、糖化血红蛋白、甘油三酯水平高于普通饮食组（P<0.05）;普通饮食组瘦素、血糖、糖化血红蛋白、甘油三酯水平高于普通饮食干预组（P<0.05）;T2DM大鼠模型各组瘦素、血糖、糖化血红蛋白、甘油三酯水平均明显高于对照组（P<0.01）。高脂饮食组大鼠脂联素水平明显低于高脂饮食干预组（P<0.01）;高脂饮食干预组脂联素水平低于普通饮食组（P<0.05）;普通饮食组脂联素水平低于普通饮食干预组（P<0.05）;T2DM大鼠模型各组脂联素水平均明显低于对照组（P<0.01）。脂联素与血糖,瘦素与血糖均有相关性（R<-0.06/R>0.06,P<0.05）。结论：严格的饮食控制及运动有助于控制2型糖尿病大鼠血糖水平的稳定,其可能与控制调节大鼠体内瘦素及脂联素水平有关。     

儿童单纯肥胖症血清瘦素、脂联素相关性研究及意义

目的:检测单纯肥胖症患儿血清中瘦素、脂联素水平,评价其临床意义.方法:依据儿童单纯肥胖症诊断标准选取40名患儿,男女各20名,选取20名年龄、性别类同的健康儿童作为对照组.应用ELISA法检测患儿血清瘦素及脂联素水平,与健康儿童进行比较及男女两组之间比较.结果:与对照组相比,患儿血清脂联素水平降低,瘦素水平升高,差异有统计学意义(P<0.05),男女两组比较,差异无统计学意义(P>0.05).结论:肥胖症儿童脂联素、瘦素水平的变化与儿童肥胖症发病密切相关,对儿童肥胖症的发展趋势及预后判断有一定意义,脂联素、瘦素素水平是肥胖发生的预测指标.     

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。     

蚕蛹油对大鼠非酒精性脂肪肝形成的影响

目的观察蚕蛹油对高脂大鼠模型的非酒精性脂肪肝形成的影响。方法SD大鼠100只,雌雄各半,按体重并参考血脂水平随机分为9组:空白对照组,高脂对照组,预防低剂量组,预防中剂量组,预防高剂量组,治疗低剂量组,治疗中剂量组,治疗高剂量组,及阳性对照组(月见草油),分别喂饲各种饲料。于第11周处死大鼠,检测肝脏的肝重指数和肝脏甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、丙二醛(malondialde-hyde,MDA)水平。结果实验11周末,预防组、治疗组和阳性对照组大鼠的肝重指数,肝脏TG、TC及MDA水平均明显低于高脂对照组(P<0.05),并具有剂量依赖性。结论蚕蛹油可通过调整脂质代谢,具有十分显著的预防和治疗非酒精性脂肪肝形成的效果,优于月见草油。     

中国汉族人群PNPLA3 I148M 多态性影响脂联素水平及非酒精性脂肪性 肝病遗传易感性的相关性研究*

目的:探讨在中国人群中PNPLA3 I148M基因型、脂联素与非酒精性脂肪性肝病的遗传易感性的相关性,及PNPLA3基因型与空腹血清脂联素水平的关系。方法:对96例NAFLD患者和76名正常对照,采用多聚酶链反应(PCR)及直接测序法检测PNPLA3基因型。计量资料结果均用均数±标准差(X±S)表示,经方差齐性检验后,行t检验;性别、基因型及等位基因频率的比较行X2检验。结果:中国汉族人群中,存在PNPLA3基因I148M多态性,I148M G等位基因频率分布在NAFLD(64.89%)与正常对照组(34.87%)、NASH组(71.70%)与SS组(56.09%)中比较差异均有统计学意义(P<0.05)。病例对照分析显示:148GG基因携带者与148CC基因携带者相比较,前者发生NAFLD的比值比(OR)为3.45(95%CI:2.21~5.41,P<0.05),发生NASH的OR为1.98(95%CI=1.08~3.64,P<0.05)。PNPLA3基因rs738409多态性与血清ALT水平有关(P<0.05),对NASH组分层分析,148GG基因型BMI、ALT、FINS均高于148CC基因型(P<0.05),血清HDL水平低于148CC基因型和148GC基因型(P<0.05),这些结果提示等位基因G与肝脏炎症和肝脏脂肪增加有相关性.Ordinal Logistic回归分析显示PNPLA3 I148M多态性与低浓度血清脂联素水平相关(<6μg/ml)(OR=2.78,95%CI=1.765~4.384,P<0.05)。结论:中国汉族人群中,PNPLA3基因I148M多态性与NAFLD的遗传易感性及脂联素的分泌调节相关,是决定NAFLD个体遗传易感性的重要因素。     

别嘌醇对高尿酸血症大鼠血清脂联素的影响

目的观察高尿酸血症大鼠血清脂联素的改变,探讨别嘌醇对高尿酸血症大鼠血清脂联素的影响及意义。方法 36只雄性SD大鼠随机分为3组。使用高酵母膏饲料联合氧嗪酸钾混悬液腹腔注射6周诱导大鼠高尿酸血症模型。别嘌醇治疗组除给予造模剂外同时给予别嘌醇灌胃。6周后处死大鼠,检测血清尿酸、脂联素、一氧化氮,免疫组化法检测大鼠主动脉内膜层eNOS的表达量。结果与正常对照组相比模型组大鼠血尿酸显著升高[(216.0±6.2)vs(45.1±5.6),P<0.05],血清脂联素、一氧化氮及主动内膜层内皮型一氧化氮合酶表达量显著降低[(52.6±7.9)vs(63.6±9.2),(17.2±3.3)vs(24.1±2.0),(38.3±4.5)vs(48.3±4.2),P<0.05]。别嘌醇治疗组血尿酸降低[(44.8±4.3)vs(216.0±6.2),P<0.05],血清脂联素和一氧化氮水平升高[(159.6±9.2)vs(52.6±7.9),(22.1±2.2)vs(17.2±3.3),P<0.05],主动脉内膜内皮型一氧化氮合酶蛋白表达增加[(46.1±4.2)vs(38.3±4.5),P<0.05]。脂联素与一氧化氮呈正相关(r=0.057),与血尿酸呈负相关(r=-0.48)。结论别嘌醇处理可一定程度逆转高尿酸血症可诱导的大鼠血清脂联素的降低,别嘌醇可能是上调内皮型一氧化氮合酶的激动剂。     

运动对高脂饲料喂养大鼠骨骼肌和肝脏组织脂联素-脂联素受体-腺苷酸活化蛋白激酶通路的影响

目的：探讨运动影响高脂喂养大鼠骨骼肌和肝脏组织在腺苷酸活化蛋白激酶（AMPK）通路上的可能机制。方法：40只雄性SD大鼠随机分为4组（n=1 0）：正常对照组（C组）：正常饮食不运动;正常饮食运动组（E组）：正常饮食同时进行10周游泳运动;高脂饮食对照组（H组）：高脂饲料喂养不运动;高脂饮食运动组（HE组）：高脂饲料喂养同时进行10周游泳运动。采用实时荧光定量PCR检测大鼠骨骼肌和肝脏脂联系受体1（AdipoR1）,Adipo R2 mRNA表达,Western blot检测大鼠骨骼肌和肝脏腺苷酸活化蛋白激酶α（AMPKα）蛋白表达及磷酸化水平。结果：股四头肌AdipoR1 mRNA、肝脏AdipoR2 mRNA表达在H组显著低于C组（P<0.05）;HE组股四头肌和肝脏AMPKα（Thr172）磷酸化水平显著高于H组（P<0.05）,分别较H组高43.2%和51.1%。结论：高脂喂养导致大鼠骨骼肌和肝脏A dipoR1/R2 mRNA表达下调,运动提高了大鼠骨骼肌和肝脏AMPKα（Thr172）磷酸化水平。     

高脂饮食诱导肥胖与肥胖抵抗型非酒精性脂肪肝大鼠模型的建立

目的:利用高脂饲料复制肥胖与肥胖抵抗型非酒精性脂肪肝SD大鼠模型。方法:体质量100±10g的雄性SD大鼠140只,按照体重随机抽取120只用于模型建立,喂食高脂、高能饲料。连续8周后,将体质量大于正常对照组平均体质量+1.96倍标准差的模型大鼠作为肥胖型非酒精性脂肪肝组(NO组),体质量小于正常对照组平均体质量+1.0倍标准差的作为肥胖抵抗型非酒精性脂肪肝组(NOR组)。8周内动态观察大鼠的一般情况、体质量变化,8周末每组随机取8只处死,比较血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、胆固醇(TC)、甘油三脂(TG)水平变化及肝指数、脂体比,观察肝脏形态学改变。剩余20只作为正常对照组,喂食普通饲料。结果:NO与NOR组大鼠体重增长差距逐渐增大,至8w末,NO组体重显著高于NOR组及正常对照组(P0.01),脂肪重量和脂体比均显著升高,NO组脂肪重量显著高于NOR组(P0.05,0.01),但脂体比间未见显著差异;NO与NOR组TG、ALT显著升高(P0.05),其中NO组大鼠血清TG、TC显著高于NOR组(P0.05);两组肝重量和肝指数均显著升高,NO组肝重量显著高于NOR组(P0.05,0.01),但肝指数间未见显著差异,两组肝细胞内均弥散大量脂肪空泡。结论:利用高脂饲料成功建立肥胖与肥胖抵抗型非酒精性脂肪肝SD大鼠模型,与人类发病特征相似,为肥胖与非酒精性脂肪的研究提供更有针对性的动物模型。     

脂联素的研究进展

脂联素（adiponectin）是一种由脂肪细胞特异性高分泌,具有多种生物学功能的特殊蛋白质它直接作用于肝脏、骨骼肌和血管,能提高胰岛素敏感性,增强脂肪酸β氧化,抵制血管炎症反应,最新研究还发现脂联素和骨生成密切相关。与其它脂肪因子不同的是,循环中脂联素的浓度与人体脂肪含量成反比,会因TNF-α的作用而上调,会被噻唑烷二酮类药物所抑制,还受到胰岛素抵抗和炎症反应的影响脂联素受体有2类,分别为AdipoR1和AdipoR2,AdipoR1主要分布在骨骼肌上,AdipoR2则高表达于肝脏组织。本文主要综述了脂联素及其受体的结构、生物学功能和研究进展。     

运动对老年肥胖大鼠脂联素的影响

目的：探讨运动对老年肥胖大鼠内脏脂肪组织脂联素mRNA和蛋白质表达、血浆脂联素浓度及胰岛素抵抗的影响。方法：取雄性SD大鼠,鼠龄21 d,分青春期、壮年期和老年期三个阶段喂养高脂饲料（脂肪率为36.3%~40.0%）,建立老年肥胖模型。鼠龄达到60周后,取自然生长老年大鼠随机分为对照组（C）和老年运动组（AE）,n=6;取老年肥胖大鼠随机分为肥胖对照组（OC）和肥胖运动组（OE）,n=6。动物跑台坡度0°,运动速度及时间为（15 m/min×15 min）,4组/次,组间休息5 min,每次共运动60 min,5次/周,持续运动8周。8周后,检测内脏脂肪组织脂联素mRNA和蛋白质表达,测定血糖、血浆脂联素浓度和胰岛素浓度,计算胰岛素抵抗。结果：运动干预后,与对照组比较,肥胖对照组大鼠脂联素mRNA和蛋白质表达显著减低,血糖浓度和胰岛素抵抗明显增高;而老年运动组大鼠脂联素mRNA和蛋白质表达显著增高。与肥胖对照组大鼠比较,肥胖运动组大鼠脂联素mRNA和蛋白质表达显著增高、血浆脂联素水平增高,血糖浓度和胰岛素抵抗明显减低。结论：老年肥胖大鼠内脏脂肪组织脂联素mRNA和蛋白质表达均降低,伴随胰岛素抵抗、血糖升高。运动能显著增加其内脏脂肪组织脂联素mRNA和蛋白质表达,升高血浆脂联素水平,改善胰岛素抵抗,降低血糖。     

MicroRNAs in the Pathogenesis of Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD), or, more accurately, metabolic associated fatty liver disease, accounts for a large proportion of chronic liver disorders worldwide and is closely associated with other conditions such as cardiovascular disease, obesity, and type 2 diabetes mellitus. NAFLD ranges from simple steatosis to nonalcoholic steatohepatitis (NASH) and can progress to cirrhosis and, eventually, also hepatocellular carcinoma. The morbidity and mortality associated with NAFLD are increasing rapidly year on year. Consequently, there is an urgent need to understand the etiology and pathogenesis of NAFLD and identify effective therapeutic targets. MicroRNAs (miRNAs), important epigenetic factors, have recently been proposed to participate in NAFLD pathogenesis. Here, we review the roles of miRNAs in lipid metabolism, inflammation, apoptosis, fibrosis, hepatic stellate cell activation, insulin resistance, and oxidative stress, key factors that contribute to the occurrence and progression of NAFLD. Additionally, we summarize the role of miRNA-enriched extracellular vesicles in NAFLD. These miRNAs may comprise suitable therapeutic targets for the treatment of this condition.     

Gender Specific Association of Serum Leptin and Insulinemic Indices with Nonalcoholic Fatty Liver Disease in Prediabetic Subjects

Adipose tissue-derived hormone leptin plays a functional role in glucose tolerance through its effects on insulin secretion and insulin sensitivity which also represent the risk factors for nonalcoholic fatty liver disease (NAFLD). The present study explored the gender specific association of serum leptin and insulinemic indices with NAFLD in Bangladeshi prediabetic subjects. Under a cross-sectional analytical design a total of 110 ultrasound examined prediabetic subjects, aged 25–68 years consisting of 57.3% male (55.6% non NAFLD and 44.4% NAFLD) and 42.7% female (57.4% non NAFLD and 42.6% NAFLD), were investigated. Insulin secretory function (HOMA%B) and insulin sensitivity (HOMA%S) were calculated from homeostasis model assessment (HOMA). Serum leptin showed significant positive correlation with fasting insulin (r = 0.530, P = 0.004), postprandial insulin (r = 0.384, P = 0.042) and HOMA-IR (r = 0.541, P = 0.003) as well as significant negative correlation with HOMA%S (r = -0.388, P = 0.046) and HOMA%B (r = -0.356, P = 0.039) in male prediabetic subjects with NAFLD. In multiple linear regression analysis, log transformed leptin showed significant positive association with HOMA-IR (β = 0.706, P <0.001) after adjusting the effects of body mass index (BMI), triglyceride (TG) and HOMA%B in male subjects with NAFLD. In binary logistic regression analysis, only log leptin [OR 1.29 95% (C.I) (1.11–1.51), P = 0.001] in male subjects as well as HOMA%B [OR 0.94 95% (C.I) (0.89–0.98), P = 0.012], HOMA-IR [OR 3.30 95% (C.I) (0.99–10.95), P = 0.049] and log leptin [OR 1.10 95% (C.I) (1.01–1.20), P = 0.026] in female subjects were found to be independent determinants of NAFLD after adjusting the BMI and TG. Serum leptin seems to have an association with NAFLD both in male and female prediabetic subjects and this association in turn, is mediated by insulin secretory dysfunction and insulin resistance among these subjects.     

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兔肝组织硫化氢与一氧化氮的关系

目的观察非酒精性脂肪性肝病（NAFLD）兔肝组织硫化氢（H2S）、一氧化氮（NO）浓度,探讨H2S、NO在NAFLD发病中的作用。方法 40只日本大耳白兔数字法随机分为重度NAFLD组（重度组）、轻度NAFLD组（轻度组）、空白对照组（对照组）。重度组给予高脂饲料160 g/（兔.d）,轻度组给予高脂饲料80 g/（兔.d）＋普通饲料80 g/（兔.d）,对照组给予普通饲料160 g/（兔.d）。均饲养13周。实验前后采集血浆标本,同步检测甘油三酯（TG）、胆固醇（TC）;肝组织匀浆检测NO、H2S浓度。肝组织HE染色,光镜观察肝脏病理学。结果⑴TC、TG：饲养前重度组、轻度组、对照组TC、TG比较差异无统计学意义（P〉0.05）,饲养后重度组TC、TG分别为（32.12±1.25）、（6.02±2.12）mmol/L,轻度组TC、TG分别为（18.34±2.10）、（4.39±1.93）mmol/L,均高于饲养前（P﹤0.01）,饲养后重度组TC、TG高于轻度组（P﹤0.01）。⑵肝组织NO：重度组（132.4±20.7μmol/g蛋白）和轻度组（95.4±19.8μmol/g蛋白）肝组织NO浓度显著高于对照组（74.9±34.7μmol/g蛋白,P﹤0.01）,重度组又显著高于轻度组（P﹤0.01）。⑶肝组织H2S浓度：与对照组比较,重度组和轻度组肝组织H2S明显下降（P﹤0.01）,重度组与轻度组比较下降更显著（P﹤0.05）。⑷肝脏病理学：重度组肝脏病理学改变呈重度NAFLD,轻度组呈轻度～中度NAFLD。结论 NO、H2S参与NAFLD的发生、发展,通过干预NO、H2S防治NAFLD可能是未来方向。     

非酒精性脂肪肝大鼠PPARα基因表达及脂代谢和胰岛素水平的变化

目的观察非酒精性脂肪肝（NAFLD）大鼠肝组织中PPARα基因的表达,并用PPARct激动剂进行干预,探讨其与胰岛素抵抗、脂代谢紊乱的关系。方法大鼠随机分为①正常对照组、②高脂模型组、③PPARα激动剂干预组,利用高脂饮食建立大鼠非酒精性脂肪肝模型。12周后,检测大鼠血脂、肝功能、血糖、胰岛素水平及胰岛素抵抗指数;RT-PCR法分析PPARα基因的表达;观察肝脏的形态学改变。结果PPARa激动剂可降低NAFLD大鼠转氨酶、血脂水平及胰岛素抵抗指数,可促进NAFLD大鼠中PPARa基因的表达;肝脏形态学明显改善。结论PPARα激动剂能改善NAFLD大鼠脂质代谢紊乱,有明显的保肝降酶作用,具有适度的胰岛素增敏作用。PPARα及其配体在NAFLD发病机制及治疗中的进一步深入研究,将为临床防治NAFLD提供新的思路。     

Association of Adiponectin Gene Polymorphism with Nonalcoholic Fatty Liver Disease in Taiwanese Patients with Type 2 Diabetes

Objective

Patients with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) have a higher prevalence of cardiovascular diseases. In this study we investigated the frequency of single nucleotide polymorphisms (SNPs) of several candidate genes associated with NAFLD in Taiwanese patients with type 2 diabetes mellitus (DM) and NAFLD and in those with DM but without fatty liver disease.

Methods

We enrolled 350 patients with type 2 DM and NAFLD and 209 patients with DM but without NAFLD. Body mass index (BMI), % body fat (% BF), glycated hemoglobin (HbA1c), high molecular weight (HMW) isoform of adiponectin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) levels were measured. Thirteen SNPs in 5 genes (adiponectin, leptin, peroxisome proliferator-activated receptor alpha, adiponutrin/patatin-like phospholipase domain-containing protein 3 and peroxisome proliferator-activated receptor γ co-activator 1α ) were measured.

Results

Only adiponectin rs266729 polymorphism was associated with susceptibility to NAFLD (p = 0.001). Subgroup analysis revealed that the proportion of subjects with homozygous genotype GG was higher in patients with NAFLD (31%) than in controls (11%) and that the proportions of heterozygous CG and homozygous CC were higher in controls (37% and 52%, respectively) than in patients with NAFLD (33% and 36%, respectively). Patients with NAFLD carrying the GG genotype of rs266729 showed significantly lower serum HMW adiponectin levels than patients carrying the GC or CC genotype (3.75±0.37 vs. 3.99±0.66 vs. 4.79±0.58 μg/ml, p< 0.001). Body fat and serum HMW adiponectin levels were the strongest predictors of developing NAFLD (p < 0.001 and 0.004, respectively).

Conclusions

In patients with type 2 diabetes gene polymorphism of adiponectin rs266729 is associated with risk of NAFLD. G allele of rs266729 is associated with hypoadiponectinemia. Low serum adiponectin level may precipitate liver steatosis in patients with type 2 diabetes.     

Increased Soluble Leptin Receptor Levels in Morbidly Obese Patients With Insulin Resistance and Nonalcoholic Fatty Liver Disease

The adipocyte hormone, leptin has been demonstrated to have profibrogenic actions in vitro and in animal models. However, no correlation was found between plasma leptin levels and fibrosis stage in humans. Thus, our aim was to study whether soluble leptin receptor (SLR) or free leptin index (FLI; calculated as the ratio of leptin to SLR), may correlate better with the features of metabolic syndrome and with the histological grade and stage of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH). We studied a population (n = 104) of morbidly obese patients undergoing bariatric surgery. Data including BMI, type 2 diabetes mellitus, hypertension, and hyperlipidemia were obtained. Plasma fasting leptin and SLR, fasting glucose and insulin were measured, and homeostasis model of assessment insulin resistance (HOMA_IR) index and FLI were calculated. All patients had intraoperative liver biopsies. Leptin levels correlated with the BMI. The multiple regression analysis indicated that increasing HOMA and decreasing FLI were predictors of steatosis in the liver (P < 0.0003). SLR levels were positively correlated with the presence of diabetes mellitus and the stage of fibrosis. In conclusion, increased SLR levels in morbidly obese patients with diabetes are correlated with the stage of liver fibrosis, and may reflect progressive liver disease.     

非酒精性脂肪性肝病蛋白质组学研究进展

非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)是一种常见慢性肝脏疾病,其发病率呈逐年上升趋势,但发病机制尚未明确,诊疗手段仍不完善.蛋白质组学(proteomics)的出现使NAFLD研究有了进一步的发展,相关研究已达21个.目前,蛋白质组学技术可以研究疾病相关的分子改变,从而寻找新的生物标志物和治疗靶标.在此,对蛋白质组学在NAFLD诊断及分期、发病机制和其他相关领域研究进展作一个较为全面的综述.首先,对研究中遇到的研究对象、样本种类、实验方法和标志物特征选择进行经验性总结.其次,除了介绍如何运用蛋白质组学研究病因、危险因素和重要分子在NAFLD发病机制中的作用,还介绍NAFLD发病机制的亚细胞蛋白质组学、修饰蛋白质组学以及蛋白质组学与转录组学相结合的研究实例.此外,对差异蛋白质的分析策略和价值作了重点阐述,收集到一些有望成为NAFLD治疗靶标的候选分子.最后,结合新技术展望研究新空间,以期能够有助于推动蛋白质组学在寻找新的疾病标志物、探索疾病分子机制和治疗靶标中开辟新的途径.     

非酒精性脂肪性肝病大鼠肝脏PPAR-γ的表达

目的：研究PPAR-γ在非酒精性脂肪性肝病（NAFLD）大鼠肝脏组织中的表达,探讨非酒精脂肪性肝病可能的发病机制。方法：雄性SD大鼠30只,随机分为A（正常组）15只普通饮食,B（高脂组）15只高脂饮食。8周后,自两组各随机抽取2只大鼠处死,光镜观察证实脂肪肝造模成功,继续喂养4周后处死所有大鼠,取血清做免疫生化检查,取肝组织标本,分别以光镜观察做出NAS评分,免疫组化和PCR法检测肝组织PPAR-γ蛋白的表达。结果：1.高脂饮食可以成功的复制NAFLD的大鼠模型;2.血清GLU、TC、TG、HDL-C、LDL-C在高脂组表达量较正常组明显升高,差异具有统计学意义（P〈0.05）;3.免疫组化显示：高脂组PPAR-γ表达量较正常组升高;结论：1.高脂饮食可成功复制NAFLD模型;2.PPAR-γ在NAFLD大鼠肝脏成脂性改变中具有重要作用。