The Correlation Study Of The Conventional Cigarette And Electronic Cigarette On Non-alcoholic Fatty Liver Disease

Part 1.The correlation study of smoking and non-alcoholic fatty liver diseaseObjective:To analyze the correlation between smoking and nonalcoholic fatty liver disease(NAFLD),to provide a scientific basis and reference for smoking cessation in NAFLD patients and smokersMethods:The clinical data of 1200 patients aged 30-70 years who were admitted to the respiratory inpatient ward,outpatient department,smoking cessation outpatient department and physical examination center of the people's hospital of Northern Jiangsu Affiliated to Yangzhou University from February 2019 to August 2019 were retrospectively analyzed After excluding those who did not meet the inclusion criteria,a total of 225 patients were included in the study.Patients were divided into NAFLD group and non-NAFLD group based on whether they had NAFLD or not.Independent sample T test and chi-square test were used to analyze whether there were differences in age,gender,height,body weight,body mass index(BMI),triglycerides(TG),cholesterol(TC),high-density lipoprotein(HDL),low density lipoprotein(LDL),diabetes,hypertension,smoking between the two groups.Then Logistic regression analysis was used to correct for confounders to analyze the correlation between smoking and NAFLD.After adjusting for confounding factors such as diabetes,gender,body mass index(BMI),height,weight,triglyceride(TG),cholesterol(TC),etc.,the correlation between active smoking,passive smoking and NAFLD was analyzed.Among NAFLD patients,the smoking NAFLD patients were divided into the active smoking group and the passive smoking group according to the different smoking modes,and the relationship between smoking mode and liver function of NAFLD patients was analyzed by one-way analysis of variance.Among NAFLD patients who were active smokers,the patients were divided into the heavy smoking group,the moderate smoking group and the light smoking group according to the different smoking dose,and the relationship between the different smoking dose and the liver function of NAFLD patients was analyzed.Results:(1)There were statistically significant differences in height,weight,BMI,TG,diabetes mellitus and smoking between the NAFLD group and the non-nafld group(p<0.05),but no statistically significant differences in age,gender,TC or hypertension(p>0.05).(2)In the non-adjusted Logistic regression model,there was an association between smoking and NAFLD(OR:2.17,95%CI:1.26,3.73),and there was still an association between smoking and NAFLD after adjusting for body weight and BMI(OR:3.69,95%CI:1.85,7.36).After adjusting for the effects of diabetes,the association was further expanded(OR:3.82,95%CI:1.88,7.79).In model 3,the influence of TG,HDL and LDL was further adjusted,and the correlation between smoking and NAFLD was still found(OR:2.60,95%CI:1.09,6.21).The probability of NAFLD in non-smokers was 2.60 times that of non-smokers,suggesting that smoking was an independent risk factor for NAFLD.(3)In the unadjusted model,there was an association between active smoking and NAFLD(OR:2.22,95%CI:1.18,3.75),and between passive smoking and NAFLD(OR:1.74,95%CI:0.96,3.02).In model 1,after adjusting for gender,diabetes,TG,HDL,LDL,BMI,body weight and other confounding factors,an association was still found between active smoking and NAFLD(OR:2.76,95%CI:1.35,6.92),and between passive smoking and NAFLD(OR:2.38,95%CI:1.01,5.68).In model 1,active smokers had a 2.76 times greater risk of NAFLD than nonsmokers,and passive smokers had a 2.38 times greater risk of NAFLD than non-smokers.(4)In patients with NAFLD,there was a statistically significant difference in liver function between the active smoking group and the passive smoking group(p<0.05).Alanine transaminase(ALT)and aspartate aminotransferase(AST)in the active smoking group were higher than that in the passive smoking group.In active NAFLD patients,ALT and AST were higher in the heavy smoking group than in the moderate smoking group,ALT and AST were higher in the moderate smoking group than in the light smoking group,and ALT and AST were higher in the light smoking group than in the never smoking group(p<0.05).ALT and AST were also significantly higher than normal in NAFLD patients who had never smoked.Conclusion:(1)Smoking is an independent risk factor for NAFLD,and both active and passive smoking were independently associated with NAFLD.(2)In patients with NAFLD,abnormal liver function is related to smoking style,and active smoking causes more liver damage than passive smoking.(3)In NAFLD patients with active smoking,abnormal liver function is related to smoking dose,and there is dose-response effect of active smoking on liver function of NAFLD.The more smoking,the worse liver function.Part 2.The correlation study of the conventional cigarette and electronic cigarette on non-alcoholic fatty liver diseaseObjective:To analyze the correlation between conventional cigarettes and e-cigarettes and NAFLD in mice,compare the liver damage caused by conventional cigarettes and e-cigarettes in mice,and explore the mechanism of liver damage caused by conventional cigarettes and e-cigarettes,so as to provide scientific basis and reference for controlling the use of conventional cigarettes and e-cigarettes.Methods: 8 week old C57BL/6 male mice(n=30)were selected as the research object.After 2 weeks of standard diet feeding,they were randomly divided into control group,conventional cigarette group and electronic cigarette group,with 10 mice in each group.Mice in the conventional cigarette group smoked marlboro brand conventional cigarettes through the fumigation box for 24 weeks,mice in the e-cigarette group smoked the new e-cigarette iqosthrough the fumigation box for 24 weeks,and mice in the control group breathed normal air without any treatment for 24 weeks.All mice were weighed regularly.After 24 weeks,the mice were killed and their blood and liver samples were collected.Using mouse blood specimen,through the analysis of the automatic biochemical analyzer blood glucose,TG,TC,ALT,AST,lactate dehydrogenase(LDH),and other biochemical indicators,by enzyme linked immunosorbent assay(ELISA),interleukin 6(IL-6),interleukin 8(IL-8),interleukin 1 beta(IL-1P),tumor necrosis factor alpha(TNF-a)assessment of inflammatory factors such as inflammation,through the corresponding kits malondialdehyde(MDA)and superoxide dismutase(SOD)evaluation level of oxidative stress.HE staining and masson staining were performed on the liver specimens to observe the liver pathology and analyze whether the liver had steatosis and fibrosis changes.In this study,animal experiments were conducted on 8-week-old male C57BL/6 mice(n=30).After 2 weeks of standard diet,they were divided into control group,conventional cigarette group and electronic cigarette group on average.The conventional cigarette group smoked marlboro cigarettes for 24 weeks,the e-cigarette group smoked IQOS e-cigarettes for 24 weeks,and the control group breathed normal air for 24 weeks.The body weight of all mice was measured,the blood of the mice was collected,the biochemical indicators related to the liver were analyzed,the liver pathological tissue sections of HE staining and masson staining were observed,and the expression levels of inflammatory factors and the degree of oxidative stress were analyzed.Results:(1)Mice in the control group had bright hair,smooth breathing and normal activity.The mice in the e-cigarette group had dark hair color,general activity and decreased appetite.Mice in the conventional cigarette group had dark hair color,less activity,decreased appetite,and some mice had shortness of breath after activity.(2)From 12 weeks to 24 weeks,the electronic cigarette group of mice and control mice,conventional cigarettes group mice and the control group on body weight in mice was statistically significant differences(p<0.05),weight is greater than the electronic smoke group,the control group also is greater than the conventional cigarettes,but conventional cigarettes mice weight of mice and electronic cigarette weight no statistically significant differences(/?>0.05).(3)ALT,AST,LDH,TC,TG and fasting blood glucose of mice in the conventional cigarette group were all higher than those in the control group and the e-cigarette group,with statistically significant differences(p<0.05).ALT,AST,LDH andTG in the e-cigarette group were higher than those in the control group,with statistically significant differences(p<0.05).There was no significant difference in fasting blood glucose between the e-cigarette group and the control group(p>0.05).(4)HE staining and masson staining were observed in the liver tissues.No abnormalities were found in the liver tissues of the control group.The liver tissues of the e-cigarette group showed a little steatosis,but no inflammatory cell infiltration,no balloon-like liver cell change' no fibrous dysplasia,and tight intercellular connections.The liver tissues of mice in the conventional cigarette group showed obvious steatosis,with some inflammatory cell infiltration,a little balloonlike hepatocytes,abnormal fibrous hyperplasia in the portal area,and the fibrous septa widened,and no pseudolobules formed in the adjacent portal area.(5)The NAFLD activity score of the control group was 0,and that of the e-cigarette group was higher than that of the control group,with statistically significant differences(p<0.05).The NAFLD activity score of mice in the conventional cigarette group was higher than that in the e-cigarette group and the control group,and the difference was statistically significant(p<0.05).(6)IL-ip,IL-8,IL-6 and TNF-a in the liver tissues of mice in the conventional cigarette group were higher than those in the e-cigarette group and the control group,with statistically significant differences(p<0.05).The level of IL-8 and TNF-a in the liver tissues of the e-cigarette group was higher than that of the control group,and the difference was statistically significant(p<0.05).There was no statistically significant difference in IL-6 and IL-1P between the e-cigarette group and the control group(p>0.05).(7)The content of MDA in liver tissues of mice in the conventional cigarette group was higher than that in the e-cigarette group and the control group,and the content of MDA in liver tissues of mice in the e-cigarette group was higher than that in the control group,with statistically significant differences(p<0.05).The SOD content in the liver tissues of the control group was higher than that of the conventional cigarette group and the e-cigarette group,and the SOD content in the liver tissues of the e-cigarette group was higher than that of the conventional cigarette group,with statistically significant differences(p<0.05).Conclusion:(1)Conventional cigarettes are an independent risk factor for NAFLD.(2)Conventional cigarettes had adverse effects on liver fimction,blood glucose and blood lipid of mice,while e-cigarettes had adverse effects on liver fimction and blood lipid of mice.No adverse effects of e-cigarettes on blood glucose were found,and the effects of e-cigarettes on liver function and blood lipid were weaker than those of conventional cigarettes.(3)By promoting oxidative stress and inflammatory response,smoke from conventional cigarettes causes fatty degeneration,inflammation,balloon-like changes and fiber proliferation in mouse liver cells,which leads to NAFLD in mice.E-cigarettes also promoted oxidative stress and inflammation in mouse livers through aerosols,causing a small amount of fatty degeneration in mouse liver cells,but not NAFLD.At the same time,the pro-oxidative stress and inflammatory response of e-cigarettes are weaker than that of conventional cigarettes.(4)Both e-cigarettes and conventional cigarettes can cause damage to the liver of mice,but e-cigarettes cause less damage to the liver of mice than conventional cigarettes.