非酒精性脂肪性肝病在代谢综合征相关的2型糖尿病发病中的作用

目的: 探讨非酒精性脂肪性肝病(NAFLD)在代谢综合征(MS)相关Ⅱ型糖尿病中的作用。方法: 将64只大鼠随机分为8组,分别是3月正常对照组(3NC)、3月高糖高脂组(3H)、6月正常对照组(6NC)、6月高糖高脂组(6H)、9月正常对照组(9NC)、9月高糖高脂组(9H)、12月正常对照组(12NC)和12月高糖高脂组(12H)。测定血浆丙氨酸氨基转移酶(ALT)、游离脂肪酸(FFA)、内毒素(LPS)、肿瘤坏死因子α(TNFα)、C反应蛋白(CRP)、巨噬细胞趋化蛋白-1(MCP-1)、空腹血糖(FPG)、空腹胰岛素(FINS),并计算胰岛素抵抗指数(HOMA-IR)、β细胞功能指数(HOMA-β)。取肝组织和胰腺组织切片行苏木素-伊红(HE)染色和苏丹Ⅳ染色;内脏脂肪组织行苏木素-伊红(HE)染色。以TUNEL法检测胰岛内细胞凋亡水平。结果: 与正常对照组相比,各阶段高糖高脂组大鼠血清ALT、FFA、LPS、TNFα、CRP、MCP-1、FPG、FINS和HOMA-IR水平都明显升高;而HOMA-β在第6个月出现代偿性增强后进行性衰退。高糖高脂组第3-12月胰岛凋亡细胞数量逐渐增加。结论: NAFLD(特别是脂肪肝与脂肪性肝炎)可以诱发MS相关的2型糖尿病。

Effect of non-alcoholic fatty liver disease on metabolic syndrome-rela ted type 2 diabetes

AIM: To investigate the effect of non-alcoholic fatty liver disease (NAFLD) on metabolic syndrome (MS)- related type 2 diabetes. METHODS: Sixty-four rats were randomly divided into 8 groups: normal control groups of 3 months (3NC), 6 months (6NC), 9 months (9NC) and 12 months (12NC), and high-sucrose and high-fat groups of 3 months (3H), 6 months (6H), 9 months (9H) and 12 months (12H). The serum levels of alanine transaminase (ALT), free fatty acid (FFA), endotoxin (LPS), tumor necrosis factor alpha (TNFα), C-reactive protein (CRP), monocyte chemotactic protein-1 (MCP-1), fasting plasma glucose (FPG) and fasting plasma insulin (FINS) were measured. The insulin resistance index (HOMA-IR) and beta cell function index(HOMA-β) were also calculated. The specimens of liver and pancreas were prepared for microscopic observation with HE and Sudan Ⅳ staining. The visceral adipose specimens were also prepared with HE staining. The apoptosis of islet cells was detected by TUNEL.RESULTS: Compared with normal control groups, the levels of ALT, FFA, LPS, TNFα, CRP, MCP-1, FPG, FINS and HOMA-IR in high-sucrose and high-fat groups of every phase were higher, but the level of HOMA-β in 6H group showed a compensatory increase first and then progressively decreased. Compared with normal control groups, TUNEL results showed that the number of apoptotic islet cells in high-sucrose and high-fat groups gradually increased from the 3rd to the 12th month. CONCLUSION: The NAFLD plays a trigger role in the start of MS-related type 2 diabetes.