Study On The Relationship Between Adiponectin And Nonalcoholic Fatty Liver Disease And The Effect Of Seal Oil On Patients With Nonalcoholic Fatty Liver Disease

Objective 1)To investigate the incidence and its clinical characters of fatty liver disease, evaluate the role of adiponectin in the pathogenesis of NAFLD. 2)Establish rat model of NAFLD in order to evaluate the role of adiponectin in the pathogenesis of NAFLD, to appraise the relationship between adiponectin and the degree of steatosis and inflammation in the livers of rats with NAFLD. 3)To observe the effect of seal oilω-3 polyunsaturated fatty acid (seal oil) on patients with NAFLD.Methods 1) Questionnaire investigation on middle-old employees in a medical therapy unit were taken between july and August 2006. It contains age, sex, history of drinking, past medical history, history of drug and poison usage, history of viral hepatitis. Authropometry indexes were measured on an empty stomach in early morning, including height, weight, Sbp, Dbp, BMI is calculated out by height and weight. Ultrasonic inspection was carried out, serum ALT, AST, TG, TC, VLDL-ch and FPG were detected by automatic biochemistry analyzer. 78 NAFLD patients with intact clinical data and blood sample were choosed to become the NAFLD group. 78 age- and sex-matched normal subjects were choosed from all health examination subjects to become the normal control group, excluded fatty liver, hypertension, hyperlipemia, diabetes and other diseases, with case control study method. Plasma adiponectin and Fasting insulin were detected by ELISA and RIA respectively, calculate IRI and ISI. 2)Twenty male Wistar rats were divided into two groups with ten for each randomly. Model group were fed with high fat diet while the normal control group with common diet for 12 weeks. After 12 weeks experiment, all rats were sacrificed. Histopathological changes in liver, liver wet weight and liver index were observed. The level of AST and ALT in serum, TG, TC in serum and liver tusse homogenates were measured by biochemical methods. Serum adiponectin was detected by ELISA. 3)18 patients with NAFLD were selected from out-patient clinic to become seal oil therapy group. They were treated by sea oil consecutively for 12 weeks, everyday twice and everytime four pills. ALT, AST, ALP,γ-GT, LDH, TG, TC, HDL-ch, LDL-ch, VLDL-ch, Apo-A1, Apo-B, LP-a and FPG were detected by automatic biochemistry analyzer at before therapy, the end of 4 weeks treatment, 8 weeks treatment and 12 weeks treatment. Liver and spleen spiral computed tomography were carried out at before therapy and the end of therapy.Results 1)453 fatty liver were detected in 1277 subjects, the prevalence rate is 35.47%(453/1277). In the total fatty liver patients, male is 236, account 52.10% while female is 217, account 47.90%. The male prevalence rate is obviously higher than female(P<0.01). The maximal prevalence rate group is between 51~60 years old in all patients, account 45.34%. The maximal fatty liver prevalence rate group is between 51~60 years old in male, account 55.29%, while the maximal fatty liver prevalence rate group is between 61~70 years old in female, account 44.68%. The fatty liver prevalence rate in≤60 years old, male is obviously higher than that in female (P<0.01). According to etiological factor, nonalcoholic fatty liver disease account 75.72%, alcoholic fatty liver disease patients account 13.25%, fatty liver patients with viral hepatitis account 5.30% and fatty liver patients caused by other reasons account 5.73% in 453 fatty liver patients. The cholecystolithiasis detection rate in fatty liver patients(8.39%,38/453)is higher than that in non-fatty liver subjects (4.61%,38/824)(P<0.01). In NAFLD group, 26 NAFLD patients accompanied with metabolism syndrome (33.33%,26/78). Compared with the normal control group, BMI, Sbp, Dbp, ALT, AST, TG, TC, VLDL-ch, FBG, Ins and IRI in NAFLD group is significantly increased(P<0.01), plasma adiponectin level and ISI is siginificantly decreased(P<0.01). 2)The NAFLD rat model was successfully established with fat diet for 12 weeks. Compared with the normal control group, the model group developed moderate-serious steatosis and focus infiltration of inflammatory cells and punctiform necrosis in hepatic lobules, with significant increase on liver wet weight, liver index, histological activity index, level of serum AST, TC and TC, TG in liver homogenate(sP<0.01), serum ALT(P<0.05)and decrease of serum adiponectin. There was no relationship between serum adiponetin and the degree of steatosis and inflammation in the livers of rats with NAFLD. 3)Compared with before therapy, serum LP-a was decreased significantly after 4 weeks and 8 weeks treatment (P<0.01), serum Apo-A1 was decreased significantly after 12 weeks treatment(P< 0.05), liver-to-spleen attenuation ratio has descend tendency, but there was no significant difference after 12 weeks treatment(P>0.05).Conclusion 1) The fatty liver prevalence rate is 35.47% in this health examination, the male morbidity rate is obviously higher than female, the maximal fatty liver prevalence rate group is 51~60 years old in all patients, account 45.34%, the fatty liver prevalence rate in male is obviously higher than female in no more than 60 years old subjects. 2) Nonalcoholic fatty liver disease was the predominant etiological factor in fatty liver disease. 3) The cholecystolithiasis detection rate in fatty liver patients is higher than non-fatty liver subjects. 4) NAFLD is closely correlated with obesity, hyperlipidemia, diabetes and metabolic syndrome. 5) Hypoadiponectinemia was found in patients and rats with NAFLD, adiponectin might play a role in the pathogenesis of NAFLD. There was no relationship between serum adiponetin and the degree of steatosis and inflammation in the livers of rats with NAFLD. 6) Seal oil exerts regulation effects against the dyslipidemia of the NAFLD patients.