植物乳杆菌对2,4,6-三硝基苯磺酸诱导的小鼠结肠炎的治疗作用

目的:评估益生菌植物乳杆菌(LP)对三硝基苯磺酸(TNBS)诱导小鼠肠道炎症损伤的治疗作用,并探讨其可能的作用机制.方法:将成年♀Balb/c小鼠随机分成3组:正常对照组(Control组),TNBS灌肠诱导小鼠结肠炎组(TNBS组)和LP干预组(TNBS+LP组).TNBS诱导肠炎模型建立后,给予TNBS+LP组小鼠灌胃LP3wk,其余两组灌胃空白对照PBS液.实验结束后对大鼠一般情况、结肠大体损伤及组织学损伤进行评估,并对各组小鼠结肠组织髓过氧化物酶(MPO)活性、LTB4含量及促炎细胞因子TNF-α和IFN-γ的表达进行测定.结果:与TNBS诱导的TNBS组相比,LP明显减轻了TNBS诱导的小鼠结肠炎症,表现为疾病活动指数下降(3.37±0.36vs0.97±0.47,P<0.05),结肠大体和组织学评分显著降低(1.11±0.61vs4.62±0.40;1.48±0.40vs5.39±1.12,均P<0.05),且LP显著降低了TNBS诱导的小鼠结肠黏膜内中性粒细胞浸润,这与MPO活性降低相一致(25.14U/g±5.22U/gvs90.3U/g±7.70U/g,P<0.05).此外,LP明显降低了T...     

Protective effects of Lactobacillus plantarum against epithelial barrier dysfunction of human colon cell line NCM460

AIM: To investigate the effects of Lactobacillus plantarum (L. plantarum ) in the intestinal permeability and expression of tight junction (TJ) using the normal human colon cell line NCM460. METHODS: Paracellular permeability of NCM460 monolayers was determined by transepithelial electrical resistance and dextran permeability. Expression of TJ proteins in NCM460 cell monolayers was detected by Western blotting and quantitative real-time polymerase chain reaction.RESULTS: L. plantarum played an important role in increasing transepithelial electrical resistance and decreasing the permeability to macromolecules of NCM460 monolayers against the disruption caused by enteropathogenic Escherichia coli (E. coli ) or enteroinvasive E. coli . L. plantarum also prevented the decrease in the expression of TJ proteins and F-actin in NCM460 cells.CONCLUSION: L. plantarum can protect against dysfunction of NCM460 intestinal epithelial barrier caused by enteropathogenic E. coli or enteroinvasive E. coli , and thus can be a potential candidate of therapeutic agents for the treatment of intestinal diseases.     

Effect of Lactobacillus plantarum LP-Onlly on gut flora and colitis in interleukin-10 knockout mice

Background and Aim: Probiotics are used in the therapy of inflammatory bowel disease. This study aimed to determine the effects of probiotic Lactobacillus plantarum LP‐Onlly (LP) on gut flora and colitis in interleukin‐10 knockout (IL‐10^?/?) mice, a model of spontaneous colitis. Methods: IL‐10^?/? and wild‐type mice were used at 8 weeks of age and LP by gavage was administered at a dose of 10⁹ cells/day per mice for 4 weeks. Mice were maintained for another one week without LP treatment. The colonic tissues were collected for histological and ultrastructural analysis at death after 4 weeks treatment of LP, and the feces were collected at 1‐week intervals throughout the experiment for the analysis of gut flora and LP using selective culture‐based techniques. Results: Compared with control mice, IL‐10^?/? mice developed a severe intestinal inflammation and tissue damage, and had an abnormal composition of gut microflora. LP administration attenuated colitis with the decreased inflammatory scoring and histological injury in the colon of IL‐10^?/? mice. In addition, LP administration increased the numbers of beneficial total bifidobacteria and lactobacilli, and decreased the numbers of potential pathogenic enterococci and Clostridium perfringens, although the decrease of coliforms was not significant after LP treatment in IL‐10^?/? mice. Conclusions: Oral administration of LP was effective in the treatment of colitis, with the direct modification of gut microflora in IL‐10^?/? mice. This probiotic strain could be used as a potential adjuvant in the therapy of inflammatory bowel disease, although further studies are required in human.     

Role of Nrf2 in chronic liver disease

Nuclear erythroid 2-related factor 2 (Nrf2) is a central regulator of antioxidative response elements-mediated gene expression. It has a significant role in adaptive responses to oxidative stress by interacting with the antioxidant response element, which induces the expression of a variety of downstream targets aimed at cytoprotection. Previous studies suggested oxidative stress and associated damage could represent a common link between different forms of diseases. Oxidative stress has been implicated in various liver diseases, including viral hepatitis, nonalcoholic fatty liver disease/steatohepatitis, alcoholic liver disease and drug-induced liver injury. Nrf2 activation is initiated by oxidative or electrophilic stress, and aids in the detoxification and elimination of potentially harmful exogenous chemicals and their metabolites. The expression of Nrf2 has been observed throughout human tissue, with high expression in detoxification organs, especially the liver. Thus, Nrf2 may serve as a major regulator of several cellular defense associated pathways by which hepatic cells combat oxidative stress. We review the relevant literature concerning the crucial role of Nrf2 and its signaling pathways against oxidative stress to protect hepatic cell from oxidative damage during development of common chronic liver diseases. We also review the use of Nrf2 as a therapeutic target to prevent and treat liver diseases.     

Lactobacillus plantarum 299: beneficial in vitro immunomodulation in cells extracted from inflamed human colon

BACKGROUND AND AIM: The present study determined the pattern of cytokine secretion (interleukin [IL]-1beta, tumor necrosis factor [TNF]-alpha, interferon [IFN]-gamma and IL-10) and their cellular sources in mononuclear cells isolated from colonic mucosa from normal and ulcerative colitis (UC) in response to probiotic and pathogenic bacteria. METHODS: Mononuclear cells were extracted from normal and active UC colonic mucosa and incubated with pure sonicates of probiotic, commensal, and pathogenic bacteria. Cytokine secretion was measured in culture supernatant and intracellular cytokine staining measured using fluorescent-activated cytometry. RESULTS: In mononuclear cells isolated from normal mucosa, significant increases in mean IL-1beta were observed with enteropathogenic Escherichia coli (286.3 +/- 138.7 pg/mL P < 0.05) and E. coli (440.5 +/- 194.0 pg/mL P < 0.01) compared with unstimulated control cells (16.7 +/- 4.8 pg/mL). In contrast, mononuclear cells isolated from active UC mucosa produced significant increases in mean IL-1beta in response to stimulation with Salmonella dublin (230.5 +/- 38.8 pg/mL P < 0.05), enteropathogenic E. coli (231.7 +/- 45.3 pg/mL P < 0.05) and E. coli (465.4 +/- 60.2 pg/mL P < 0.001) compared with unstimulated control cells (60.7 +/- 17.1 pg/mL). Escherichia coli also produced significant mean increases of TNF-alpha and IFN-gamma compared with unstimulated control cells. No significant increases in IL-1beta, TNF-alpha or IFN-gamma were observed with Lactobacillus plantarum in cells derived from normal or inflamed mucosa. Strikingly, incubation of L. plantarum with mononuclear cells isolated from active UC mucosa resulted in significant increases of mean IL-10 (327 +/- 53.5 pg/mL, P < 0.05) compared with unstimulated control cells (29.7 +/- 13.2 pg/mL). Intracellular cytokine staining confirmed T-cell and macrophage IL-10 production after L. plantarum stimulation. CONCLUSIONS: Lactobacillus plantarum demonstrates beneficial immunomodulatory activity by increasing IL-10 synthesis and secretion in macrophages and T-cells derived from the inflamed colon. This may provide a mechanism through which probiotic bacteria ameliorate inappropriate inflammation and induce tolerance.     

还原型谷胱甘肽对大鼠肝星状细胞HSC-T6增殖及核转录因子NF-E2相关因子2/血红素加氧酶-1信号通路的影响

目的 探讨还原型谷胱甘肽(GSH)对大鼠肝星状细胞HSC-T6增殖及核转录因子NF-E2相关因子2(Nrf2)/血红素加氧酶-1(HO-1)信号通路的影响.方法 分别用浓度为0、1、2、5、10 mmol/L的GSH作用于经0.1 μg/ml脂多糖活化的大鼠HSC-T6细胞24h后,四甲基偶氮唑盐比色法检测HSC-T6增殖情况,放射免疫法检测细胞上清液中透明质酸(HA)及Ⅳ型胶原的含量,实时荧光定量PCR检测Nrf2和HO-1的mRNA表达水平,免疫细胞化学染色法检测HSC-T6中Nrf2和HO-1的蛋白质表达情况,分光光度计检测HO-1的活性变化.两两比较采用t检验,两变量间的关系采用曲线拟合方法. 结果 GSH能抑制HSC-T6增殖,1、2、5、10 mmol/L组的吸光度值分别为0.79±0.02、0.74±0.03、0.70±0.02、0.62±0.01,均低于0mmol/L组的0.88±0.03(t值分别为3.16、6.09、7.17、11.94,P值均＜0.05).GSH 1、2、5、10mmol/L组的HA表达量分别为(372.98±11.01)μg/L、(320.76±16.37) μg/L、(284.46±13.17)μg/L、(239.08±16.95)μg/L,明显低于0 mmol/L组的(415.74±14.52)μg/L(t值分别为4.07、7.52、11.59、13.71,P值均＜0.05);Ⅳ型胶原表达量分别为(191.27±17.49)μg/L、(163.85±16.26) μg/L、(133.03±13.14)μg/L、(103.31±12.52) μg/L,也低于0mmol/L组的(251.47±14.06) μg/L(t值分别为4.65、7.58、10.66、13.63,P值均＜0.05).0 mmol/L组HSC-T6中Nrf2 mRNA相对表达量(1.21±0.11)低于1、2、5、10 mmol/L组(分别为1.51±0.06、1.92±0.08、2.69±0.07、3.43±0.07),Nrf2蛋白表达的累积吸光度值(17.84±0.61)也低于1、2、5、10 mmol/L组(分别为23.85±0.20、27.90±0.32、33.69±0.75、38.64±0.38); HO-1 mRNA相对表达量(1.25±0.09)低于1、2、5、10 mmol/L组(分别为1.43±0.08、1.73±0.07、2.10±0.08、2.64±0.07),HO-1蛋白表达的累积吸光度值(16.77±0.31)也低于1、2、5、10 mmol/L组(20.75±0.30、24.84±0.24、28.89±0.19、33.88±0.19),差异均有统计学意义(P值均＜0.05).HO-1的活性也随GSH浓度增加而上升.结论 GSH可抑制HSC-T6增殖,减少其细胞外基质HA及Ⅳ型胶原分泌,其机制可能与GSH对HSC-T6的Nrf2/HO-1信号通路调控有关.     

无机砷对角质细胞红系相关因子及其下游抗氧化酶蛋白表达的影响

目的探讨无机砷暴露对皮肤角质细胞红系相关因子2(Nrf2)及其调控的下游抗氧化酶NAD(P)H醌氧化还原酶1(NQO1)和血红素单加氧酶-1(HO-1)蛋白表达的影响。方法 25μmol/L亚砷酸钠(NaAsO2)作用于人类皮肤角质细胞系HaCaT细胞株0.5、3、6、12、24 h,采用western blot法检测细胞内Nrf2、NQO1和HO-1的蛋白表达情况。结果25μmol/L NaAsO2暴露0.5、3、6、12、24 h均能够显著诱导HaCaT细胞的Nrf2蛋白表达(P<0.01),Nrf2蛋白在NaAsO2暴露3、6、12 h表达量呈现高峰,24 h则呈下降趋势,但仍显著高于对照组;NQO1的蛋白表达仅在暴露后3 h显著高于对照组(P<0.01),暴露时间延长后则显著下降,6、12、24 h的NQO1蛋白表达水平明显低于对照组(P<0.05或P<0.01);HO-1蛋白则从暴露3 h开始呈现明显的诱导表达,且随染毒时间的延长(6、12、24 h)表达持续增强,具有明显的时间-效应关系(P<0.01)。结论无机砷暴露能够诱导人类皮肤角质细胞系HaCaT细胞的Nrf2及其调控的下游抗氧化酶NQO1和HO-1的蛋白表达。     

蜂毒溶血肽改善非酒精性脂肪肝大鼠肝组织脂肪沉积作用及其机制研究*

目的 探讨蜂毒溶血肽对非酒精性脂肪性肝病（NAFLD）大鼠肝脂肪变性的保护作用及其机制。方法 随机将40只SD大鼠分成对照组、模型组、小剂量蜂毒溶血肽处理组和大剂量蜂毒溶血肽处理组。采用高脂饲料喂养建立NAFLD模型,再分别给予蜂毒溶血肽10 μg·kg^-1·d^-1和100μg·kg^-1·d^-1或生理盐水皮下注射,连续12 w。采用Western blot法检测核转录因子E2相关因子 2（Nrf2）和血红素加氧酶-1（HO-1）表达。结果 大剂量蜂毒溶血肽处理组大鼠体质量和肝质量分别为（380.2±20.8） g和（10.4±1.3） g,显著低于模型组【分别为（435.2±22.1） g和（14.3±1.4） g,P<0.05】,血清AST和ALT水平分别为（88.0±10.4） U/L和（49.3±6.2） U/L,显著低于模型组【分别为（159.7±18.9） U/L和（77.7±6.8）U/L,P<0.05】,血糖、TC、TG和LDL-C水平分别为（8.7±1.8） mmol/L、（1.6±0.2） mmol/L、（0.8±0.1）mmol/L和（0.3±0.1） mmol/L,显著低于模型组【分别为（18.3±2.4）mmol/L、（2.8±0.3） mmol/L、（1.5±0.2） mmol/L和（0.5±0.1）mmol/L,P<0.05】,血清超氧化物歧化酶（SOD）、丙二醛（MDA）和谷胱甘肽（GSH）水平分别为（82.1±6.6） U/L、（6.3±0.8） nmol/mL和（8.7±0.9） mmol/L,与模型组的（30.4±5.3）U/L、（13.1±1.6） nmol/mL和（2.3±0.5） mmol/L比,差异显著（P<0.05）,肝组织Nrf2和HO-1表达分别为（1.4±0.2）和（1.2±0.1）,显著高于模型组【分别为（0.3±0.1）和（0.3±0.1）,P<0.05】。结论 蜂毒溶血肽可以调节NAFLD大鼠血糖和血脂代谢,减轻肝脂肪变程度,改善肝功能,其机制可能与调控Nrf2和HO-1表达,缓解氧化应激损伤有关。     

甘氨酸对高脂饮食诱导小鼠高脂血症的保护作用

目的研究甘氨酸(Gly)降低高脂血症小鼠血脂的作用。方法将40只小鼠随机分为对照组、高脂组、小剂量和大剂量甘氨酸处理组,在不同处理2周后,取血测定小鼠血酯水平、肝组织丙二醛(MDA)和超氧化物歧化酶(SOD)活性,及观察肝组织病理形态学表现。结果与对照组比,高脂饮食小鼠TC、LDL、HDL-C、MDA含量明显增高(P0.05),SOD活性下降(P0.05);与高脂血症动物比,甘氨酸处理小鼠血TC、LDL明显降低(P0.01),MDA含量下降(P0.05),SOD活性升高(P0.05);高脂血症小鼠肝组织可见弥漫性脂肪变性,而甘氨酸处理动物肝细胞内脂滴小且少。结论甘氨酸可通过调节血脂代谢增强抗氧化能力,从而能防治高脂血症所致的肝脂肪变性。     

Fatty liver disease: Disparate predictive ability for cardiometabolic risk and all-cause mortality

AIM: To assess the association of a surrogate of fatty liver disease (FLD) with incident type-2 diabetes, coronary heart disease, and all-cause mortality.METHODS: In a prospective population-based study on 1822 middle-aged adults, stratified to gender, we used an algorithm of fatty liver index (FLI) to identify associations with outcomes. An index ≥ 60 indicated the presence of FLD. In Cox regression models, adjusted for age, smoking status, high-density lipoprotein cholesterol, and systolic blood pressure, we assessed the predictive value of FLI for incident diabetes, coronary heart disease (CHD), and all-cause mortality.RESULTS: At a mean 8 year follow-up, 218 and 285 incident cases of diabetes and CHD, respectively, and 193 deaths were recorded. FLD was significantly associated in each gender with blood pressure, total cholesterol, apolipoprotein B, uric acid, and C-reactive protein; weakly with fasting glucose; and inversely with high-density lipoprotein-cholesterol and sex hormone-binding globulin. In adjusted Cox models, FLD was (with a 5-fold HR) the major determinant of diabetes development. Analyses further disclosed significant independent prediction of CHD by FLD in combined gender [hazard ratio (HR) = 1.72, 95% confidence interval (CI): 1.17-2.53] and men (HR = 2.35, 95%CI: 1.25-4.43). Similarly-adjusted models for all-cause mortality proved, however, not to confer risk, except for a tendency in prediabetics and diabetic women.CONCLUSION: A surrogate of FLD conferred significant high risk of diabetes and coronary heart disease, independent of some metabolic syndrome traits. All-cause mortality was not associated with FLD, except likely in the prediabetic state. Such a FLI may reliably be used in epidemiologic studies.     

Nuclear factor erythroid 2-related factor 2-mediated signaling and metabolic associated fatty liver disease

Oxidative stress is a key driver in the development and progression of several diseases, including metabolic associated fatty liver disease (MAFLD). This condition includes a wide spectrum of pathological injuries, extending from simple steatosis to inflammation, fibrosis, cirrhosis, and hepatocellular carcinoma. Excessive buildup of lipids in the liver is strictly related to oxidative stress in MAFLD, progressing to liver fibrosis and cirrhosis. The nuclear factor erythroid 2-related factor 2 (NRF2) is a master regulator of redox homeostasis. NRF2 plays an important role for cellular protection by inducing the expression of genes related to antioxidant, anti-inflammatory, and cytoprotective response. Consistent evidence demonstrates that NRF2 is involved in every step of MAFLD deve-lopment, from simple steatosis to inflammation, advanced fibrosis, and ini-tiation/progression of hepatocellular carcinoma. NRF2 activators regulate lipid metabolism and oxidative stress alleviating the fatty liver disease by inducing the expression of cytoprotective genes. Thus, modulating NRF2 activation is crucial not only in understanding specific mechanisms underlying MAFLD progression but also to characterize effective therapeutic strategies. This review outlined the current knowledge on the effects of NRF2 pathway, modulators, and mechanisms involved in the therapeutic implications of liver steatosis, inflammation, and fibrosis in MAFLD.     

Effects of interventions on oxidative stress and inflammation of cardiovascular diseases

Excessive oxidative stress and low-grade chronic inflammation are major pathophysiological factors contributing to the development of cardiovascular diseases (CVD) such as hypertension, diabetes and atherosclerosis. Accumulating evidence suggests that a compromised antioxidant system can lead to excessive oxidative stress in cardiovascular related organs, resulting in cell damage and death. In addition, increased circulating levels of pro-inflammatory cytokines, such as tumor necrosis factor α, interleukin-6 and C-reactive protein, are closely related to morbidity and mortality of cardiovascular complications. Emerging evidence suggests that interventions including nutrition, pharmacology and exercise may activate expression of cellular anti-oxidant systems via the nuclear factor erythroid 2-related factor 2-Kelchlike ECH-associated protein 1 signaling pathway and play a role in preventing inflammatory processes in CVD. The focus of the present review is to summarize recent evidence showing the role of these anti-oxidant and anti-inflammatory interventions in cardiovascular disease. We believe that these findings may prompt new effective pathogenesis-oriented interventions, based on the exercise-induced protection from disease in the cardiovascular system, aimed at targeting oxidant stress and inflammation.     

Nrf 2抗氧化系统在慢性阻塞性肺疾病中的作用

C O PD可致肺功能进行性减退,严重影响患者的生活质量,且目前为止尚无确切有效的治疗方法。尽管确切的病因仍不清楚,但是氧化应激被认为在疾病发病过程中扮演着重要角色。核因子相关因子2（Nrf2）是体内调节抗氧化系统的关键性转录因子之一,其目的基因表达的增加能增强细胞抗氧化作用。本文通过对氧化应激和 Nrf2介导的抗氧化系统,及其在COPD中的作用进行综述。     

植物乳杆菌对白细胞介素-10基因敲除小鼠结肠炎的治疗作用

目的 评估植物乳杆菌（Lactobacillus plantarum,Lp）对白细胞介素-10基因敲除(interleukin-10 knockout,IL-10-/-)小鼠结肠炎的治疗作用,并探讨其可能的作用机制。方法 8周龄雌性IL-10-/-小鼠和WT小鼠各20只,各自平均分成2组,即WT组、WT+Lp组、IL-10-/-组和IL-10-/- +Lp组。WT和1L-10-/-组予0.5 ml PBS灌胃,WT+ Lp和IL-10-/-+ Lp组予0.02g Lp(0.5 ml)灌胃,每天摄入Lp1×109菌落形成单位(CFU),持续灌胃4周后实验结束。实验开始前（0周）及开始后每隔1周收集小鼠新鲜粪便1次,直至实验结束。实验结束后将小鼠处死,记录各组小鼠体重变化,并测量其结肠长度和湿重,切取新鲜结肠组织标本做病理切片及结肠黏膜促炎因子肿瘤坏死因子(TNF)-α和干扰素-γ(IFN-γ)检测。并对小鼠新鲜粪便作选择性细菌培养,观察Lp在正常小鼠和炎症小鼠体内的定植情况及其对肠道菌群的调节作用。结果 与WT小鼠相比,IL-10-/-小鼠腹泻较重,体重亦明显下降(P＜0.05),存在严重营养不良,而经Lp治疗后IL-10-/-小鼠腹泻得到缓解,体重亦明显增加(P＜0.05)。病理学检查显示,所有IL-10-/-小鼠皆发生肠道炎症,经Lp治疗后肠道炎症得到明显改善,黏膜溃疡、上皮增生及黏膜固有层淋巴细胞和中性粒细胞浸润明显减轻,病理学评分明显降低(P＜0.01)。IL-10-/-小鼠经Lp治疗后结肠湿重及湿重与长度比出现明显变化(P＜0.01),结肠水肿和增厚现象得到明显改善。IL-10-/-组小鼠结肠TNF-a和IFN-γ含量分别为(377.4±84.4) μg/g和（602.6±108.1）μg/g,均较WT组明显增加[（139.2±32.7）μg/g和（173.0±52.4）μg/g,P＜0.05）]。Lp干预4周后,IL-10-/- +Lp组小鼠结肠TNF-α和IFN-γ的含量分别为(207.2±65.7) μg/g和(442.1±138.4) μg/g,均较IL-10-/-组显著降低(P＜0.05)。IL-10-/-小鼠体内肠道菌群出现紊乱。结论 Lp能有效减轻IL-10-/-小鼠肠道炎症,对结肠炎起到一定的治疗作用,且这种治疗作用与Lp调节肠道菌群及抑制促炎细胞因子的表达有关。     

Impact of metabolic syndrome criteria on cardiovascular disease risk in people with newly diagnosed type 2 diabetes

Aims/hypothesis We investigated the prognostic implication of metabolic syndrome according to modified National Cholesterol Education Program criteria and the implication of individual features of metabolic syndrome on cardiovascular disease (CVD) and CHD in a 5-year community-based study of people with newly diagnosed type 2 diabetes. Methods We entered 562 participants, aged 30–74 years, into a cross-sectional analysis and 428 participants (comprising those who were CVD-free at study entry) into a prospective analysis. In both analyses, the association of metabolic syndrome features with CVD/CHD was studied. Binary logistic regression, a Cox regression model and Fisher's exact test were used for statistical analyses. Results At diagnosis of type 2 diabetes, metabolic syndrome was independently associated with CVD (odds ratio [OR] 2.54; p=0.006) and CHD (OR 4.06; p=0.002). In the 5-year follow-up, metabolic syndrome at baseline was an independent predictor of incident CVD (hazard ratio [HR] 2.05; p=0.019). An increase in the number of individual features of the metabolic syndrome present at the time of diagnosis of type 2 diabetes was associated with a linear increase in incident CVD risk (trend p=0.044) with an almost five-fold increase when all five features were present, compared with hyperglycaemia alone (HR 4.76; p=0.042). Increasing age (HR 1.07; p<0.001), female sex (HR 0.62; p=0.032), total cholesterol (HR 1.43; p=0.01) and lipid-lowering therapy (HR 0.32; p<0.001) were also independent predictors of risk. Conclusions/interpretation Metabolic syndrome at baseline is associated with an increased risk of incident CVD in the 5 years following diagnosis of type 2 diabetes. CVD-free survival rates declined incrementally as the presence of metabolic syndrome features increased. Thus, identifying the features of metabolic syndrome at diagnosis of type 2 diabetes is potentially a useful prognostic tool for identifying individuals at increased risk of CVD.     

Carotid lesions in outpatients with nonalcoholic fatty liver disease

AIM： To ascertain whether carotid lesions are more prevalent in outpatients with incidental findings of nonalcoholic fatty liver disease （NAFLD） at abdominal ultrasound （US）. METHODS： One hundred and fifty-four consecutive outpatients （age range 24-90 years, both sexes） referred by general practitioners for abdominal US, and drinking less than 20 g alcohol/day, underwent carotid US for an assessment of carotid intima-media thickness （c-IMT） and carotid plaque prevalence. Hepatic steatosis, visceral fat thickness and subcutaneous fat thickness were also assessed at ultrasonography. RESULTS： Higher c-IMT values were found in the presence of NAFLD （90 patients）, even after adjustment for indices of general and abdominal obesity and for the principal cardiovascular risk factors （0.84 ± 0.10 mm vs 0.71 ± 0.10 mm, P 〈 0.001）. The prevalence of carotid plaques was 57.8% in the patients with NAFLD vs 37.5% in the patients without this condition （P = 0.02）. The adjusted relative risk of having carotid plaques for patients with NAFLD was 1.85 （95% CI： 1.33-2.57, P 〈 0.001）.CONCLUSION： An incidental finding of hepatic steatosis may suggest the presence of silent carotid atherosclerotic lesions.     

Proteinuria and metabolic syndrome as predictors of cardiovascular death in non-diabetic and type 2 diabetic men and women

Aims/hypothesis Proteinuria predicts cardiovascular disease (CVD), but it is unclear whether this is explained by the association of the metabolic syndrome with proteinuria. Therefore, we investigated proteinuria and the metabolic syndrome as independent predictors of CVD death in men and women. Methods The cohort comprised 574 non-diabetic men, 707 non-diabetic women, 371 diabetic men and 349 diabetic women, all free of CVD at baseline. Modified World Health Organization criteria were used to define the metabolic syndrome, and a urinary protein concentration of ≥0.1 g/l (or ≥0.2 g/l) to define proteinuria. The endpoint was CVD mortality during the 18-year follow-up. Results Among non-diabetic men, CVD mortality per 1,000 person-years was as follows: no metabolic syndrome, no urinary protein group: 5.3; no metabolic syndrome, positive for urinary protein: 8.9; positive for metabolic syndrome, no urinary protein: 13.3; and positive for metabolic syndrome and urinary protein: 14.9. For non-diabetic women the corresponding values were: 0.9, 2.3, 4.9 and 7.9, respectively. Among diabetic men, CVD mortality per 1,000 person-years was 15.2, 32.5, 23.6 and 42.0 for the respective groups. Among diabetic women it was 25.3, 38.0, 26.3 and 40.3 (urinary protein in all cases defined as ≥0.1 g/l). In multivariate Cox models including both urinary protein and metabolic syndrome, the hazard ratios (HRs, 95% CI) of proteinuria for CVD mortality were 1.5 (0.9–2.4) in non-diabetic men, 1.8 (0.8–4.2) in non-diabetic women, 1.6 (1.0–2.6) in diabetic men and 1.6 (1.1–2.3) in diabetic women. Urinary protein as a continuous variable was associated with CVD mortality in all groups. The corresponding HRs for metabolic syndrome were: 1.6 (0.9–2.7), 4.0 (1.7–9.7), 1.5 (1.1–2.0) and 1.1 (0.8–1.5). Conclusions/interpretation Proteinuria predicted CVD mortality independently of the presence of metabolic syndrome in non-diabetic and diabetic subjects. Metabolic syndrome predicted CVD mortality in non-diabetic women and in diabetic men, independently of the presence of proteinuria.     

他汀类药物在治疗非酒精性脂肪肝病中的研究进展

近年来,非酒精性脂肪肝病逐渐成为国内肝病相关死亡率的主要因素。非酒精性脂肪肝病的发病机制主要与代谢综合征相关,其危险因素主要包括肥胖、2型糖尿病、脂代谢异常等,这些危险因素与心血管疾病密切相关,心血管疾病死亡率也成为非酒精性脂肪肝病首要的死亡原因。他汀类药物是最主要的降脂药物,有证据表明,非酒精性脂肪肝病患者使用他汀类药物降脂治疗不仅能有效降低肝脏转氨酶水平,降低心血管疾病病死率,而且能有效减轻肝脏脂肪变性程度,同时可能对延缓肝脏纤维化有一定的疗效。     

男性慢性乙型肝炎患者肝细胞脂肪变危险因素分析

目的：比较男性慢性乙型肝炎（CHB）合并肝脂肪变患者与单纯 CHB 患者临床特征,寻找影响肝细胞脂肪变的危险因素。方法2010年3月～2013年3月期间,住院初治且有肝活检病理学检查的男性 CHB 患者209例,根据肝组织中有无脂质沉积分为 CHB 合并脂肪变组及单纯 CHB 组,比较两组患者血脂、血尿酸、血糖、饮酒、体质量指数和病毒载量情况,进行二元 Logistic 回归分析,了解肝脂肪变的危险因素。结果在209例男性 CHB 患者中,合并脂肪变121例（57.9%）,单纯 CHB 88例（42.1%）;CHB 合并脂肪变患者尿酸、低密度脂蛋白和甘油三酯分别为（352.5±87.1）mmol/L、（2.8±0.8）mmol/L 和（1.8±0.1）μmol/L,均显著高于单纯 CHB 患者[（310.3±69.1） mmol/L、（2.2±0.6） mmol/L 和（1.2±0.7）μmol/L,P〈0.01）];体质量指数和低密度脂蛋白水平升高是男性 CHB 患者合并肝脂肪变的危险因素（P〈0.05）。结论肥胖、血脂紊乱等代谢综合征相关表现是男性 CHB 患者肝组织脂肪变的危险因素,而饮酒或病毒载量可能不是肝脂肪变的危险因素。