Exploring The Essence Of Fatty Liver's Phlegm-Stasis Syndrome And Regulation Of Molecular Mechanism From The Genetic Polymorphism Of PPARγC161-T/CYPⅡE1

Objective To study the association of genotype frequencies of peroxisome proliferator activated-receptors-gamma C161→T and CYPⅡE1 gene with fatty liver and the essence of fatty Liver's phlegm-stasis syndrome.Methods The PCR-RFLP method was used to detect the polymorphism of PPARyC161→T and CYP CYPIIE1 gene of the 183 patients with fatty liver disease and 40 normal controls. According to TCM differentiation,183 patients with fatty liver disease were devided into three syndromes,including 79 cases of Phlegm syndrome,69 cases of blood stasis syndrome and 35 cases without significant syndrome. Biochemical parameters including serum ALT,AST,GGT,TG,TC,HDL-C, LDL-C,UA,FINS,FBG,DBP,SBP,height,weight,WC,were also assessed,and then body mass index and homoeostasis model assessment of insulin resistance (HOMA-IR=FBG×FINS/22.5) were calculated. Among them,there were 50 patients with fatty liver disease undergoing liver bioposy.Logistic univariate and multivariate regression analysis were used to analyze the independent risk factors of fatty liver disease.Results①The fatty liver group waist circumference, BMI, SBP, FBG, HOMA-IR, TG, TC, UA, ALT, AST, GGT were higher than normal controls there are significant differences(p<0.01).②PPAR-yC161-T genotype and allele frequencies in the fatty liver group had no significant difference with control group (p>0.05).PPARyC161T genotype CC and CT/TT type of comparison the control group, FBG of the genotype CT/TT higher than the genotype CC (P<0.05). There were no significant difference in PPARγC161T genotype and allele frequencies of varying degrees of fatty liver steatosis(p>0.05).③CYPⅡE1 genotype C1C2, C2C2 frequency and allele frequency of C2 in fatty liver were higher than the control group (P<0.05). CYPⅡE1 genotype C1C1 and C1C2/C2C2 type of comparison, GGT of the genotype C1C2/C2C2 higher than the genotype C1C1 (P<0.05). There were no significant difference in CYPⅡE1 genotype and allele frequencies of varying degrees of fatty liver steatosis(p>0.05).④TG, TC, LDL-C had a significant difference in Phlegm syndrome group, blood stasis syndrome group and without significant syndrome group (P<0.05). Blood stasis syndrome group had higher level than without significant syndrome group in TG(P<0.01),TC(P<0.01),LDL-C(P<0.05). Phlegm syndrome group had higher level than without significant syndrome group in TG(P<0.01),TC(P<0.05),LDL-C(P<0.05). PPAR-yC161-T genotype and allele frequencies in Phlegm syndrome group, blood stasis syndrome group and without significant syndrome group had no significant difference with control group(p>0.05).CYPⅡE1 genotype C1C2, C2C2 frequency and allele frequency of C2 in syndrome group, blood stasis syndrome group were higher than without significant syndrome group (P<0.05).⑤WC,TG,ALT were independent risk factors of fatty liver disease by using multivariate logistic regression analysis.Conclusion①CYPⅡE1 gene polymorphism was closely related with lipid peroxidation of fatty liver and the C2 allele is closely related to the incidence of fatty liver.②Lipid metabolism disorders was closely related to phlegm and blood stasis syndrome of fatty liver.③CYPⅡE1 gene polymorphism may be play a decisive role in the formation of phlegm and blood stasis syndrome, as well as the transformation of phlegm and blood stasis syndrome in the fatty liver.④WC,TG, ALT were independent risk factors of fatty liver disease.