Changes in intestinal flora in nonalcoholic fatty liver disease: their correlation with insulin resistance index,tumor necrosis factor- α,and interleukin- 6
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摘要:
目的探讨非酒精性脂肪性肝病(NAFLD)患者肠道菌群变化及其与胰岛素抵抗指数(HOMA-IR)及肿瘤坏死因子(TNF)α、白细胞介素(IL)6的相关性。方法选取2013年1月-2014年9月在葫芦岛市中心医院消化内科诊治的NAFLD患者82例作为NAFLD组,同期健康体检者60例作为对照组,收集所有研究对象的新鲜粪便和空腹血清,计算肠道定植抗力(B/E值)和HOMA-IR。用ELISA法检测血清中TNFα及IL-6的水平,分析B/E值与HOMA-IR、TNFα及IL-6的相关性。计量资料两组间比较采用t检验;多组间比较采用方差分析;相关性分析采用Pearson相关分析。结果与对照组比较,NAFLD组肠道双歧杆菌和乳杆菌数量明显减少,肠杆菌和肠球菌数量明显增加,B/E值明显下降,两组间差异均有统计学意义(P值均<0.01)。NAFLD组血ALT、AST、甘油三酯、空腹血糖、空腹胰岛素水平及HOMA-IR、TNFα、IL-6较对照组明显升高(P值均<0.01)。相关性分析显示B/E值与HOMA-IR、TNFα及IL-6均呈显著负相关性(r=-0.872、-0.461、-0.52...
Abstract:Objective To explore the changes in intestinal flora in patients with nonalcoholic fatty liver disease( NAFLD) and their correlation with homeostatic model assessment- insulin resistance( HOMA- IR) index,serum tumor necrosis factor- α( TNFα),and interleukin- 6( IL- 6). Methods Eighty- two patients with NAFLD who were diagnosed and treated in the Department of Gastroenterology in our hospital from January 2013 to September 2014 were enrolled into NAFLD group. Sixty healthy physical examinees were used as controls.Fresh feces and fasting serum of all subjects were collected to calculate intestinal colonization resistance( B / E value) and HOMA- IR. The serum levels of TNFα and IL- 6 were determined by enzyme- linked immunosorbent assay. The correlation of B / E value with HOMA- IR,TNFα,and IL- 6 was analyzed. Between- group comparison of continuous data was performed by t test,and multiple- group comparison was performed by analysis of variance. Correlation analysis was made by Pearson correlation analysis. Results Compared with the control group,the NAFLD group had significantly decreased numbers of bifidobacteria and lactobacilli,significantly increased numbers of Enterobacteriaceae and Enterococcus,and a significantly lower B / E value( all P < 0. 01). Moreover,the NAFLD group had significantly higher levels of serum alanine aminotransferase,aspartate aminotransferase,triglycerides,fasting plasma glucose,fasting serum insulin,HOMA-IR,TNFα,and IL- 6 than the control group( all P < 0. 01). Correlation analyses showed that B / E value was significantly negatively correlated with HOMA- IR,TNFα,and serum IL- 6( r =- 0. 872,P < 0. 01; r =- 0. 461,P < 0. 01; r =- 0. 523,P < 0. 01). Conclusion The changes in intestinal flora are closely related to changes in HOMA- IR and levels of TNFα and IL- 6 in patients with NAFLD,which suggest that the above factors may influence and interact with each other,contributing to the development and progression of NAFLD.
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Key words:
- fatty liver /
- enterobacteriaceae /
- insulin resistance /
- tumor necrosis factor-alpha /
- interleukin-6
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Springer出版社近日正式发行了由北部战区总医院消化内科祁兴顺医生及长征医院谢渭芬教授作为主编编写的《Portal Vein Thrombosis》一书。该书全面总结回顾了门静脉血栓的流行病学、危险因素、影像诊断、分型、对肝硬化患者预后的影响、抗凝及溶栓药物治疗、TIPS治疗、肝移植治疗及未来展望等方面的内容。该书共包括12个章节,均由近年在门静脉血栓领域发表过高水平论文的研究者撰写完成,分别来自美国、法国、意大利、葡萄牙、日本、印度、土耳其、伊朗。此外,由德国的Martin Rssle教授为本书作序,他是门静脉高压领域的国际权威专家,曾在NEJM和Lancet等高水平杂志发表多篇论著。ISBN:978-981-33-6538-4。每册定价:99.99欧元。购买途径:Springer官网,链接:https://link.springer.com/book/10.1007%2F978-981-33-6538-4。
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