肥胖及超重人群中血清Wnt5a水平与肝脏脂肪变和纤维化程度的相关性研究  

Serum Wnt5a and Its Associations with Liver Steatosis and Fibrosis in Overweight and Obese People

作　　者：梁利波[1] 王霞[2] 何訸[2] 高赟[3] 贾丹[1] 安振梅[3] 李双庆[1] 

机构地区：[1]四川大学华西医院全科医学科,成都610041 [2]四川大学华西医院实验医学科,成都610041 [3]四川大学华西医院内分泌代谢科,成都610041

出　　处：《四川大学学报（医学版）》2017年第1期7-11,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅软科学计划项目(No.20152R0105和No.20142R0165)资助

摘　　要：目的探讨肥胖及超重人群中血清Wnt5a水平与肝脏脂肪变及纤维化程度的相关性。方法 134例在我院体检中心参加体检并在内分泌代谢科就诊,同时完成了瞬时弹性扫描仪(Fibroscan)检查的肥胖或超重患者,根据Fibroscan检测结果〔肝脏实时受控衰减参数(controlled attenuation parameter,CAP)评估肝脏脂肪变性程度,瞬时肝脏弹性测量值(elasticity,E)评估纤维化程度〕分为正常对照组(27例)、轻度非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)组(51例)和中重度NAFLD组(56例)。同时测量腰围(waist circumstance,WC)、臀围(hip circumstance,HC),进行糖耐量试验和胰岛功能试验,检测血清转氨酶、血脂等,并采用酶联免疫吸附法(ELISA)测定血清Wnt5a和β-连环蛋白(β-catenin)水平。结果对照组、轻度NAFLD组和中重度NAFLD组3组间年龄、性别、体质量指数(BMI)、WC、HC差异均无统计学意义(P>0.05)。3组间空腹及餐后2h血糖、空腹胰岛素水平和胰岛素抵抗指数差异有统计学意义(P<0.05),而餐后2h胰岛素水平差异无统计学意义(P>0.05)。轻度NAFLD组与对照组的CAP值、E值、血清Wnt5a和β-catenin水平相当,差异均无统计学意义(P>0.05)。中重度NAFLD组CAP值、E值和血清Wnt5a均高于对照组和轻度NAFLD组,差异有统计学意义(P<0.05)。Spearman相关分析显示,血清Wnt5a水平与CAP值呈负相关(相关系数r=-0.19,P<0.000 1),与E值无显著相关关系(r=0.02,P=0.241)。结论血清Wnt5a水平与NAFLD有关,在肥胖或超重合并NAFLD的发病不同阶段可能起着不同的病理生理作用。Objective To determine serum Wnt5a and its associations with liver steatosis and fibrosis in overweight and obese people. Methods The study participants were recruited from those who visited our hospital for health examinations. They were divided into three groups according to body mass index （BMI）, controlled attenuation parameter （CAP）values and elasticity （E） values of liver fibroscan： Control （n= 27）, Mild NAFLD （non-alcoholic fatty liver disease, n= 51） and Moderate/severe NAFLD （n = 56）. The waist circumference （WC）, hip circumference （HC）, oral glucose tolerance test （OGTT）, insulin releasing test （IRT）, liver function, blood lipid, serum WntSa and 13 catenin of those participants were measured. Results The three groups of participants had no significant differences in age, gender, BMI, WC or HC （P〉0. 05）. Significant differences appeared in fasting glucose, 2 h postprandial glucose and fasting insulin level between the three groups （P〈0.05）, but not in 2 h postprandial insulin level （P〉0.05）. The participants with NAFLD had higher levels of serum WntSa and β- catenin than controls （P〈0.05）. WntSa level was correlated with CAP value （r=-0.19, P〈0. 000 1）, but barely with E value （r = 0.02, P=0. 241）. Conclusion Wnt5a may play a role at different stages of NAFLD in overweight/obese people.

关 键 词：肥胖 WNT5A 肝脂肪变性 肝纤维化 

分 类 号：R589.2[医药卫生—内分泌] R575[医药卫生—内科学]