Associations of insulin resistance, inflammation and liver synthetic function with very low-density lipoprotein: The Cardiovascular Health Study

被引：23

作者：

Jiang, Z. Gordon ^{[1
]}

de Boer, Ian H. ^{[2
]}

Mackey, Rachel H. ^{[3
]}

Jensen, Majken K. ^{[4
]}

Lai, Michelle ^{[1
]}

Robson, Simon C. ^{[1
]}

Tracy, Russell ^{[5
]}

Kuller, Lewis H. ^{[6
]}

Mukamal, Kenneth J. ^{[7
]}

机构：

[1] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Gastroenterol & Hepatol,Dept Med, Boston, MA 02115 USA

[2] Univ Washington, Div Nephrol, Seattle, WA 98195 USA

[3] Univ Vermont, Coll Med, Dept Pathol, Burlington, VT 05405 USA

[4] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA

[5] Univ Vermont, Coll Med, Dept Pathol & Lab Med, Burlington, VT 05405 USA

[6] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15261 USA

[7] Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02115 USA

来源：

METABOLISM-CLINICAL AND EXPERIMENTAL | 2016年 / 65卷 / 03期

关键词：

Very low-density lipoprotein (VLDL); Insulin resistance; Liver synthetic function; Non-alcoholic fatty liver disease (NAFLD); Non-alcoholic steatohepatitis (NASH); NUCLEAR-MAGNETIC-RESONANCE; NONALCOHOLIC STEATOHEPATITIS; METABOLIC SYNDROME; GLUCOSE-TOLERANCE; HEPATIC STEATOSIS; UNITED-STATES; DISEASE; ATHEROSCLEROSIS; ADULTS; SIZE;

D O I：

10.1016/j.metabol.2015.10.017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction. Production of very low-density lipoprotein (VLDL) is increased in states of metabolic syndrome, leading to hypertriglyceridemia. However, metabolic syndrome is often associated with non-alcoholic fatty liver disease, which leads to liver fibrosis and inflammation that may decrease VLDL production. In this study, we aim to determine the interactive impact on VLDL profiles from insulin resistance, impairment in liver synthetic function and inflammation. Methods. We examined cross-sectional associations of insulin sensitivity, inflammation, and liver synthetic function with VLDL particle (VLDL-P) concentration and size among 1,850 older adults in the Cardiovascular Health Study. Results. Indices for high insulin sensitivity and low liver synthetic function were associated with lower concentrations of VLDL-P. In addition, insulin resistance preferentially increased concentration of large VLDL and was associated with mean VLDL size. Indices for inflammation however demonstrated a nonlinear relationship with both VLDL-P concentration and VLDL size. When mutually adjusted, one standard deviation (SD) increment in Matsuda index and C-reactive protein (CRP) were associated with 4.9 nmol/L (-8.2 to -1.5, p = 0.005) and 6.3 nmol/L (-11.0 to -1.6, p = 0.009) lower VLDL-P concentration respectively. In contrast, one-SD increment in factor VII, a marker for liver synthetic function, was associated with 16.9 nmol/L (12.6-21.2, p < 0.001) higher VLDL-P concentration. Furthermore, a one-SD increment in the Matsuda index was associated with 1.1 nm (-2.0 to -0.3, p = 0.006) smaller mean VLDL size, whereas CRP and factor VII were not associated with VLDL size. Conclusion. Insulin sensitivity, inflammation and markers for liver synthetic function differentially impact VLDL-P concentration and VLDL size. These results underscore the complex effects of insulin resistance and its complications on VLDL production. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：92 / 99

页数：8

共 36 条

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