J Gastroenterology:慢性肝病患者中血浆游离氨基酸的减少与血清白蛋白之间的关系

2018-09-08 MedSci MedSci原创

目前,人们对于慢性肝病(CLDs)进展过程中如何发生血浆氨基酸(PFAAs)失衡,以及血浆氨基酸浓度水平与血清白蛋白(sAlb)水平相关联的了解甚少。本项研究的目的是阐明患有CLD的患者中sAlb和PFAAs之间的关系。

背景
目前,人们对于慢性肝病(CLDs)进展过程中如何发生血浆氨基酸(PFAAs)失衡,以及血浆氨基酸浓度水平与血清白蛋白(sAlb)水平相关联的了解甚少。本项研究的目的是阐明患有CLD的患者中sAlb和PFAAs之间的关系。

方法
研究人员回顾性地评估了908名患有各种慢性肝病(丙肝,乙肝。酒精性脂肪肝,非酒精性脂肪肝,PBC,自发免疫性肝炎,PSC和肝癌)的患者,从而获得PFAAs数据。总的来说,研究人员分析11类别的PFA的数据,这些数据可以在患有Child-Pugh(CP)评分系统中进行分析。

结果
在肝炎疾病进展期间,每个CLD患者中研究人员都观察到PFAAs的各种不平衡。单变量和多变量分析显示,在24种PFAAs中,血浆支链氨基酸(pBCAAs)水平与慢性丙型肝炎病毒(CHC),NAFLD / NASH患者的CP评分,尤其是sAlb评分显着相关。 在PBC的患者中sAlb和pBCAAs与酪氨酸比(BTR)之间的相关系数值分别为0.53,0.53和0.79。有趣的是,尽管NAFLD / NASH患者的pBCAAs的浓度即使在sAlb处于正常范围内也有所不同,但当sAlb低于正常范围时,pBCAAs往往较低。

结论
无论是何种CLD,以及慢性肝炎的病因如何,在疾病进展过程中研究人员都观察到pBCAAs水平降低,但总pBCAAs水平与CHC,PBC和NAFLD / NASH的PFAAs中的sAlb水平独立相关。在患有CLD的患者中,sAlb和BTR之间的相关性在PBC患者中显示最高值。在NASH患者中,即使sAlb水平保持在正常范围内,机体也经常发生pBCAAs的减少的现象。

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    2019-06-24 许安
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    2018-09-10 珙桐
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