酒精性肝病患者血清瘦素及其受体基因Gln223Arg多态性变化  

Serum leptin and leptin receptor Gln223Arg polymorphism in patients with alcoholic liver disease

作　　者：曾俊涛[1] 陈静[1] 

机构地区：[1]海南医学院附属医院,海口570102

出　　处：《山东医药》2013年第48期10-12,共3页Shandong Medical Journal

基　　金：海南省卫生厅科研立项课题项目(琼卫2011-30)

摘　　要：目的观察酒精性肝病患者血清瘦素(Lep)水平及其受体(LEPR)基因Gln223Arg多态性变化,并探讨其意义。方法选择酒精性肝病患者106例,其中酒精性脂肪性肝炎45例(AH组),酒精性肝硬化61例(AC组),同期健康体检者65例作为对照组。采用ELISA法检测血清Lep,葡萄糖氧化酶—过氧化物酶法检测空腹血糖(FPG),化学发光免疫分析法检测空腹血清胰岛素(FINS),PCR-RFLP法检测LEPR基因Gln223Arg多态性,并计算HOMA-IR。结果 AH组血清Lep、HOMA-IR分别为(8.95±1.81)ng/mL、2.44±0.25,AC组分别为(10.57±2.00)ng/mL、3.21±0.17,对照组分别为(4.44±0.81)ng/mL、1.77±0.18;AH组、AC组与对照组比较,P均<0.05。AH组、AC组血清Lep与HOMA-IR均呈正相关(r=0.45、0.38,P均<0.01)。AH组AA、A/G、GG的例数分别为3、11、31例,AC组分别为0、25、36例,对照组分别为1、12、52例;AC组与对照组比较,P<0.05。结论酒精性肝病患者血清Lep、HOMA-IR水平升高,AC组患者LEPR基因Gln223Arg杂合基因频率高于健康人群,可能通过胰岛素—瘦素轴促进胰岛素抵抗,影响体内脂肪代谢,参与酒精性肝病的发病机制。Objective To observe the serum leptin （Lep） levels and leptin receptor （LEPR） gene polymorphisms changes in patients with alcoholic liver disease, and to investigate the significance. Methods A total of 106 patients with alcoholic liver disease, including 45 patients with alcoholic steatohepatitis （AH） （AH group） and 61 patients with alcohol- ic cirrhosis （AC） （AC group）, and another 65 healthy individuals （control group） were studied. Serum levels of leptin were detected by enzyme-linked immunoabsorbent assay （ELISA）, fasting blood glucose （FPG） was detected by glucose oxidase-peroxidase method, fasting serum insulin （FINS） by chemiluminescence immunoassay, and the LEPR gene poly- morphisms were detected by PCR-RFLP, and HOMA-IR was calculated. Results The serum Lep level and HOMA-IR in the AH group were （8.95 ±1.81） ng/mL and 2.44 ±0.25, （10.57 ±2） ng/mL and 3.21 ± 0.17 in the AC group, （4.44 ± 0.81 ） ng/mL and 1.77 ± 0.18 in the control group. When we compared the AH and AC groups with the control group, statistical differences were found （ all P 〈 0.05 ）. HOMA-IR was positively correlated with serum Lep level in the AH and AC groups （ r = 0.45, 0.38 ; all P 〈 0.01 ）. The numbers of patients with AA, A/G and GG in the AH group were 3, 11 and 31 cases, and they were 0, 25 and 36 cases in the AC group, 1, 12 and 52 cases in the control group. Statisti- cal difference was found between the AC and the control group （ P 〈 0.05 ）. Conclusions The serum Lep level and HO- MA-IR increase in patients with alcoholic liver disease, and the heterozygous gene frequency of LEPR gene Gln223Arg in patients with AC is higher than that of the healthy people, which are involved in the pathogenesis of alcoholic liver disease by promoting insulin resistance and affecting fat metabolism through the insulin-leptin.

关 键 词：酒精性肝病 瘦素 瘦素受体 基因多态性 

分 类 号：R575.5[医药卫生—消化系统]