Liver Int:氧化应激与健康人群的非酒精性脂肪肝疾病发生率和死亡率相关

2020-09-17 MedSci原创 MedSci原创

非酒精性脂肪肝疾病(NAFLD)是指在没有过量饮酒的情况下肝细胞中甘油三酸酯(TG)的异常蓄积的表现,在西方国家,NAFLD正在成为最普遍的慢性肝病。

背景与目标

非酒精性脂肪肝疾病(NAFLD)是指在没有过量饮酒的情况下肝细胞中甘油三酸酯(TG)的异常蓄积的表现,在西方国家,NAFLD正在成为最普遍的慢性肝病。NAFLD涵盖了从单纯性脂肪变性到非酒精性脂肪性肝炎(NASH)以及纤维化的多种疾病。之前有研究表明,炎症明显促进了NAFLD的发展。在NAFLD期间,肝细胞不再耐受累积的脂肪酸的毒性影响,从而导致细胞稳态的功能障碍,包括线粒体β氧化和内质网应激的发生,随后导致肝细胞损伤,进而导致炎性细胞因子(TNF-α,IL-6,IL-10)的分泌和细胞死亡。硫醇(R‐SH)参与各种生物过程,例如体内的酶催化,细胞信号传导和金属络合,最重要的是,血浆或血清硫醇由于具有很高的还原活性,因此被认为是反应性物种系统性负载的整体标志,并且被认为是有效的抗氧化剂。 因此研究人员假设全身游离巯基水平是系统氧化应激的代表并与NAFLD相关,并对此进行了研究。

方法

研究人员从预防肾脏和血管性终末期疾病(PREVEND)队列研究中删选了1651名参与者,并确定了蛋白调整后的血清游离巯基浓度,NAFLD的诊断由脂肪肝指数(FLI≥60)和肝脂肪变性指数(HSI> 36)进行判断。

 

 

结果

FLI≥60的受试者经蛋白质调整的血清游离硫醇显着降低。在多变量logistic回归分析中, 即使针对潜在的混杂因素进行了调整,蛋白质调整后的血清游离硫醇也与NAFLD(FLI≥60)相关(浓度每增加1倍:0.78; [95%CI 0.64-0.96],P = .016 )。收缩压,糖尿病,目前吸烟,饮酒和总胆固醇也与NAFLD的发生相关(OR 0.80 [95%CI 0.65-0.99],P= .04)。然后再对高敏感性C反应蛋白进行调整,分层分析显示,性别(P <.02),高血压(P <.001)和高胆固醇血症(P <.003)的蛋白质校正血清游离巯基浓度与NAFLD的发生有显着关系。同时研究人员也观察到,在NAFLD(FLI≥60)的受试者中,蛋白质调整后的血清游离硫醇与全因死亡率风险显着相关(HR 0.27 [95%CI 0.17-0.45],P<.001)。

 

结论

血清游离硫醇水平降低与NAFLD的发病有显著相关关系,且与全因死亡率显着相关。游离巯基的定量分析可能是一种有效的提高普通人群中NAFLD的检出率和减少全因死亡率的手段。

 

原始出处:

Turtushikh Damba. Et al. Oxidative stress is associated with suspected non‐alcoholic fatty liver disease and all‐cause mortality in the general population. Liver International.2020.

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    2020-09-17 Psycho.Dr Du

    可以这样说,氧化应激跟各种疾病都相关!#氧化应激反应#

    0

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