非酒精性脂肪性肝病患者血清棕榈酸水平
비주정성지방성간병환자혈청종려산수평
Level of serum palmitic acid in patients with non-alcoholic fatty liver disease
  • 万方数据
    中华临床营养杂志 중화림상영양잡지
    CHINESE JOURNAL OF CLINICAL NUTRITION
    2014年 2期 92-96 ,共5页

    彭克楠%唐志鹏%刘波%赵海利%柴国静%赵晓云

    팽극남%당지붕%류파%조해리%시국정%조효운

    高脂血症%非酒精性脂肪性肝病%游离脂肪酸%气相色谱 高脂血癥%非酒精性脂肪性肝病%遊離脂肪痠%氣相色譜
    고지혈증%비주정성지방성간병%유리지방산%기상색보
    Hyperlipidemia%Non-alcoholic fatty liver disease%Free fatty acid%Gas chromatography
    目的 分析非酒精性脂肪性肝病(NAFLD)患者血清的中长链游离脂肪酸(FFAs)水平,为NAFLD的临床预防和治疗提供依据.方法 选取2011年1至5月在河北省人民医院门诊就诊的高甘油三酯(TG)患者125例,依据肝脏B超诊断分为伴NAFLD者64例(HF组)和不伴NAFLD者61例(H组);另选择邯郸中心医院同期查体健康人员63名为健康对照组(N组).采用气相色谱法测定血清中长链FFAs.比较3组患者的体重指数(BMI)、腹围、血压、空腹血糖(FBG)及血脂水平,包括TG、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C).结果 H组与N组比较,BMI[(25.24±1.41) kg/m2比(24.32±1.12) kg/m2,P =0.004]、腹围[(84.72±1.34) cm比(77.33±0.89) cm,P=0.010]和舒张压[(77.35±1.21) mmHg比(75.21±1.61) mmHg,P=0.014]显著升高,血清TG[(2.86±0.55) mmol/L比(0.93±0.27) mmol/L,P=0.000]和TC水平[(4.56±0.66) mmol/L比(4.36 ±0.47) mmol/L,P=0.000]也显著升高;血清中肉豆蔻酸(C14∶0)[(0.49±0.04)％比(0.36±0.01)％,P=0.011]、棕榈酸(C16∶0)[(18.36±0.47)％比(15.97±0.30)％,P=0.000]、棕榈油酸(C16∶1) [(1.00±0.12)％比(0.58±0.02)％,P=0.001]及油酸(C18∶1)水平[(18.20±0.70)％比(12.23±0.37)％,P=0.000]均显著增高,而硬脂酸(C18∶0)[(7.52±0.22)％比(8.15±0.28)％,P=0.012]、二十碳二烯酸(C20∶2)[(0.61±0.07)％比(1.03±0.17)％,P =0.000]、二十碳三烯酸(C20∶3)[(1.77±0.15)％与(2.49±0.18)％,P=0.002]及二十二碳六烯酸(C22∶6)水平[(1.44±0.08)％比(1.67±0.09)％,P=0.014]均显著降低.HF组与H组比较,体重[(85.76±3.10) kg比(71.45±2.88) kg,P=0.003]、腹围[(96.30±2.05) cm比(84.72±1.34) cm,P=0.000]、收缩压[(117.12±1.15) mmHg比(113.23±1.25) mmHg,P=0.009]和舒张压[(79.54±1.42) mmHg比(77.35±1.21) mmHg,P=0.016]均显著升高,FBG、TG、TC、HDL-C和LDL-C差异均无统计学意义(P均＞0.05);血清中棕榈酸(C16∶0)水平显著上升[(19.54±0.30)％比(18.36±0.47)％,P=0.000],二十碳二烯酸(C20∶2)水平较N组降低但高于H组[(0.78±0.09)％比(1.03±0.17)％,(0.78±0.09)％比(0.61±0.07)％,P均=0.000].结论血清中棕榈酸增加可能是NAFLD的重要危险因素,饮食中应减少饱和脂肪酸,增加不饱和脂肪酸,有助于防治NAFLD.
    목적 분석비주정성지방성간병(NAFLD)환자혈청적중장련유리지방산(FFAs)수평,위NAFLD적림상예방화치료제공의거.방법 선취2011년1지5월재하북성인민의원문진취진적고감유삼지(TG)환자125례,의거간장B초진단분위반NAFLD자64례(HF조)화불반NAFLD자61례(H조);령선택함단중심의원동기사체건강인원63명위건강대조조(N조).채용기상색보법측정혈청중장련FFAs.비교3조환자적체중지수(BMI)、복위、혈압、공복혈당(FBG)급혈지수평,포괄TG、총담고순(TC)、고밀도지단백담고순(HDL-C)화저밀도지단백담고순(LDL-C).결과 H조여N조비교,BMI[(25.24±1.41) kg/m2비(24.32±1.12) kg/m2,P =0.004]、복위[(84.72±1.34) cm비(77.33±0.89) cm,P=0.010]화서장압[(77.35±1.21) mmHg비(75.21±1.61) mmHg,P=0.014]현저승고,혈청TG[(2.86±0.55) mmol/L비(0.93±0.27) mmol/L,P=0.000]화TC수평[(4.56±0.66) mmol/L비(4.36 ±0.47) mmol/L,P=0.000]야현저승고;혈청중육두구산(C14∶0)[(0.49±0.04)％비(0.36±0.01)％,P=0.011]、종려산(C16∶0)[(18.36±0.47)％비(15.97±0.30)％,P=0.000]、종려유산(C16∶1) [(1.00±0.12)％비(0.58±0.02)％,P=0.001]급유산(C18∶1)수평[(18.20±0.70)％비(12.23±0.37)％,P=0.000]균현저증고,이경지산(C18∶0)[(7.52±0.22)％비(8.15±0.28)％,P=0.012]、이십탄이희산(C20∶2)[(0.61±0.07)％비(1.03±0.17)％,P =0.000]、이십탄삼희산(C20∶3)[(1.77±0.15)％여(2.49±0.18)％,P=0.002]급이십이탄륙희산(C22∶6)수평[(1.44±0.08)％비(1.67±0.09)％,P=0.014]균현저강저.HF조여H조비교,체중[(85.76±3.10) kg비(71.45±2.88) kg,P=0.003]、복위[(96.30±2.05) cm비(84.72±1.34) cm,P=0.000]、수축압[(117.12±1.15) mmHg비(113.23±1.25) mmHg,P=0.009]화서장압[(79.54±1.42) mmHg비(77.35±1.21) mmHg,P=0.016]균현저승고,FBG、TG、TC、HDL-C화LDL-C차이균무통계학의의(P균＞0.05);혈청중종려산(C16∶0)수평현저상승[(19.54±0.30)％비(18.36±0.47)％,P=0.000],이십탄이희산(C20∶2)수평교N조강저단고우H조[(0.78±0.09)％비(1.03±0.17)％,(0.78±0.09)％비(0.61±0.07)％,P균=0.000].결론혈청중종려산증가가능시NAFLD적중요위험인소,음식중응감소포화지방산,증가불포화지방산,유조우방치NAFLD.
    Objective To analyze the serum levels of medium-and long-chain free fatty acids (FFAs)in patients with hyperlipidemic non-alcoholic fatty liver disease (NAFLD) in order to shed some light on prevention and treatment of NAFLD.Methods The clinical data of 125 patients with high triglyceride (TG)levels who were treated in Hebei General Hospital from January 2011 to May 2011 were analyzed in this study.They were further divided into HF group (n =64) and H group (n =61) based on the presence of NAFLD or not.In addition,63 healthy individuals were recruited from the Central Hospital of Handan during the same period as the control group (N group).Serum medium-and long-chain FFAs were detected by gas chromatography.The body mass index (BMI),abdominal circumference,blood pressure,fasting blood glucose (FBG),and serum lipids including TG,total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),and low-density lipoprotein cholesterol (LDL-C) were measured.Results Compared with the N group,the H group had significantly higher BMI [(25.24 ± 1.41) kg/m2 vs.(24.32 ± 1.12) kg/m2,P =0.004],abdominal circumference [(84.72 ± 1.34) cm vs.(77.33 ±0.89) cm,P =0.010],and diastolic blood pressure [(77.35±1.21) mmHgvs.(75.21 ±1.61) mmHg,P=0.014]; also,the serum TG [(2.86±0.55) mmol/Lvs.(0.93±0.27) mmol/L,P=0.000] andTC levels [(4.56±0.66) mmol/Lvs.(4.36±0.47) mmol/L,P=0.000],serum myristic acid (C14∶0) [(0.49±0.04)％ vs.(0.36±0.01)％,P=0.011],palmitic acid (C16 ∶ 0) [(18.36 ± 0.47) ％ vs.(15.97 ± 0.30) ％,P =0.000],palmitoleic acid (C16∶ 1) [(1.00±0.12)％ vs.(0.58±0.02)％,P=0.001],and oleic acid (C18 ∶ 1) [(18.20±0.70) ％ vs.(12.23 ± 0.37) ％,P =0.000] all significantly increased,while stearic acid (C18 ∶ 0) [(7.52 ±0.22)％ vs.(8.15 ±0.28)％,P=0.012],eicosadienoic acid (C20 ∶ 2) [(0.61 ±0.07)％ vs.(1.03 ±0.17) ％,P =0.000],eicosatrienoic acid (C20 ∶ 3) [(1.77 ± 0.15) ％ vs.(2.49 ± 0.18) ％,P =0.002],and docosahexenoic acid (C22 ∶ 6) [(1.44 ± 0.08) ％ vs.(1.67 ± 0.09) ％,P =0.014] significantly decreased.Compared with the H group,the HF group had significantly higher weight [(85.76 ± 3.10) kg vs.(71.45 ±2.88) kg,P =0.003],abdominal circumference [(96.30 ±2.05) cm vs.(84.72 ± 1.34) cm,P=0.000],systolic blood pressure [(117.12 ±1.15) mmHg vs.(113.23 ±1.25) mmHg,P=0.009],and diastolic blood pressure [(79.54 ± 1.42) mmHg vs.(77.35 ± 1.21) mmHg,P =0.016],whereas the sreum FGB,TG,TC,HDL-C,and LDL-C showed no significant differentces; serum palmitic acid (C16 ∶ 0)[(19.54 ± 0.30) ％ vs.(18.36 ± 0.47) ％,P =0.000] also significantly increased.The serum level of eicosadienoic acid (C20 ∶ 2) in HF group was between that in N group and H group [(0.78 ± 0.09) ％ vs.(1.03 ±0.17)％,(0.78±0.09)％ vs.(0.61 ±0.07)％,both P=0.000].Conclusions The increased serum level of palmitic acid may be a risk factor for NAFLD.Reducing saturated fatty acids and increasing unsaturated acids in diets may be helpful for preventing NAFLD.
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