脂肪因子Vaspin 在非酒精性脂肪性肝病中的表达及其临床意义*

The expression and clinical significance of adipokine Vaspin in nonalcoholic fatty liver disease*

摘要:

目的 初步探索Vaspin在非酒精性脂肪性肝病（NAFLD）肝脏组织中的表达及其临床意义。方法 回顾分析2016年10月—2019年10月首都医科大学附属北京地坛医院收治的78例NAFLD超声引导下肝脏组织细 针穿刺患者临床病理资料。采用HE染色和网织Gomori银染色观察肝脏组织的炎症程度和纤维化程度；免疫组织 化学染色法检测Vaspin和转化生长因子-β（TGF-β）的表达；分析肝脏组织Vaspin、TGF-β的表达与肝脏组织 炎症程度、纤维化程度、血清总胆固醇（TCHO）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度 脂蛋白胆固醇（LDL-C）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、γ-谷氨酰基转移酶（GGT）、碱性磷酸酶 （ALP）、总胆红素（TBIL）、直接胆红素（DBIL）、空腹血浆葡萄糖（FPG）、糖化血红蛋白（HbA1c）的相关性； 采用Logistic回归模型分析NAFLD的影响因素。结果 Vaspin表达分级与TG呈负相关（rs =-0.279，P <0.05）， 与LDL-C、FPG呈正相关（rs =0.352和0.312，均P <0.05）。TGF-β表达分级与ALP呈负相关（rs =-0.225，P < 0.05）。Logistic 回归分析显示，Vaspin 表达分级［O^R=2.987 （95% CI：1.065，8.379）］、ALT ［O^R=1.062 （95% CI：1.014，1.112）］、TBIL［O^R=1.502（95% CI：1.147，1.967）］、FPG［O^R=13.111（95% CI：1.430， 120.195）］是发生NAFLD的独立危险因素。结论 肝脏组织Vaspin高表达提示NAFLD患者病情较重。

Abstract:

Objective To investigate the expression and clinical significance of visceral adipose tissue-derived serine protease inhibitor (Vaspin) in nonalcoholic fatty liver disease (NAFLD). Methods The clinical and pathological data of 78 patients with NAFLD undergoing ultrasound-guided fine-needle aspiration in liver tissues from October 2016 to October 2019 in our hospital were retrospectively analyzed. Hematoxylin and eosin staining and Gomori methenamine silver staining were used to observe the degree of inflammation and fibrosis of liver tissues. The immunohistochemical staining was used to detect the expression of Vaspin and transforming growth factor-β (TGF-β). The correlations of the expression of Vaspin and TGF-β with the degree of inflammation, fibrosis, serum total cholesterol (TCHO), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gammaglutamyltransferase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) were analyzed. Logistic regression model was applied to analyze the influencing factors for NAFLD. Results The Vaspin expression negatively correlated with TG (rs = -0.279，P < 0.05), but positively correlated with LDL-C and FPG (rs = 0.352 and 0.312, both P < 0.05); TGF-β expression negatively correlated with ALP (rs =-0.225, P < 0.05). Logistic regression analysis showed that Vaspin expression [O^R = 2.987 (95% CI: 1.065, 8.379)], ALT [O^R = 1.062 (95% CI: 1.014, 1.112)], TBIL [O^R = 1.502 (95% CI: 1.147, 1.967)], and FPG [ O^R = 13.111 (95% CI: 1.430, 120.195)] were risk factors for NAFLD. Conclusion The high expression of Vaspin in liver tissue indicates the severe condition of NAFLD.