炎症和胰岛素抵抗在肥胖儿童非酒精性脂肪性肝病中的发病作用

IF 0.1 Q4 MEDICINE, GENERAL & INTERNAL
Y. Stepanov, N. Zavhorodnia, O. Tatarchuk, I. Klenina, I. S. Konenko, O. Petishko
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引用次数: 0

摘要

胰岛素抵抗(IR)和非酒精性脂肪性肝病(NAFLD)之间的首要假说仍有争议,这需要进一步的研究。研究NAFLD儿童与正常体重和肥胖的非NAFLD儿童相比,根据肝损害程度的细胞因子谱和IR标志物之间的差异,并研究它们与人体测量和仪器参数的关系。材料和方法。纳入患者170例,年龄6 ~ 17岁(平均12.15±2.51岁)。肝脂肪变性采用瞬时弹性图测定。根据患者是否存在肝脂肪变性、非酒精性脂肪性肝炎(NASH)和肥胖分为4组:1 - 37例肥胖合并NASH患者;2 ~ 53例单纯性脂肪变性肥胖患者;3 ~ 65例肥胖无NAFLD患者;4组(对照组):体重正常,无NAFLD患者15例。通过HOMA-IR计算,检查了人体测量参数、碳水化合物代谢和细胞因子谱。与对照组相比,NAFLD患儿血清IL-6和tnf - α水平升高(P小于0.05),NAFLD患儿血清IL-10水平降低(P小于0.05),NASH患儿血清tnf - α/IL-10比值升高(P小于0.05)。在NAFLD儿童中,与对照组和无脂肪变性的肥胖儿童相比,HOMA-IR呈进行性增加(P小于0.05)。血清IL-6、tnf - α水平、tnf - α/IL-10比值、HOMA-IR与肥胖程度、脂肪组织分布参数、肝脂肪变性程度、CAP呈正相关,IL-10水平与肝脂肪变性程度呈负相关。在肥胖NAFLD儿童中,HOMA-IR、IL-6、tnf - α的显著升高与脂肪过度堆积、脂肪组织分布参数、肝脏脂肪变性程度和CAP相关,可能有助于儿童NAFLD的早期诊断。在NASH儿童中,TNFα/IL-10比值的显著增加使我们可以考虑将该指标作为儿科临床实践中诊断不同形式NAFLD的可能标志。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pathogenetic role of inflammation and insulin resistance in non-alcoholic fatty liver disease in obese children
The hypothesis of primacy between insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD) remains debatable, which requires additional research. Aim. To examine the differences between cytokine profile and IR markers in children with NAFLD depending on liver damage degree compared to children with normal weight and obesity without NAFLD and to study their association with anthropometric and instrumental parameters. Materials and methods. 170 patients aged 6–17 years (mean 12.15 ± 2.51 years) were included. Hepatic steatosis was determined by transient elastography. Patients were divided into 4 groups according to the presence of hepatic steatosis, non-alcoholic steatohepatitis (NASH) and obesity: group 1 – 37 obese patients with NASH; group 2 – 53 obese patients with simple steatosis; group 3 – 65 obese patients without NAFLD; group 4 (control) – 15 patients with normal weight without NAFLD. Anthropometric parameters, carbohydrate metabolism with the HOMA-IR calculation, and cytokine profile were examined. Results. An increase in serum IL-6 and TNFα levels in NAFLD children compared to the control group (P ˂ 0.05), a decrease in IL-10 level in NAFLD children (P ˂ 0.05), and an increase in TNFα/IL-10 ratio (P ˂ 0.05) in NASH children compared to obese children without steatosis were demonstrated. In NAFLD children, a progressive increase in HOMA-IR was found compared to the control group and obese children without steatosis (P ˂ 0.05). The serum IL-6, TNFα levels, TNFα/IL-10 ratio, and HOMA-IR were positively correlated with obesity degree, adipose tissue distribution parameters, hepatic steatosis degree, CAP, while IL-10 level was negatively correlated with the hepatic steatosis degree. Conclusions. In obese NAFLD children, a significant increase in HOMA-IR, IL-6, TNFα is correlated with excessive fat accumulation, adipose tissue distribution parameters, hepatic steatosis degree, and CAP that may be useful for early diagnosis of NAFLD in children. A significant increase in the TNFα/IL-10 ratio in NASH children allows to consider this indicator as a probable marker for diagnosis of different NAFLD forms in pediatric clinical practice.
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来源期刊
Zaporozhye Medical Journal
Zaporozhye Medical Journal MEDICINE, GENERAL & INTERNAL-
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