上海大学生非酒精性脂肪肝与载脂蛋白E基因多态性的关系

目的 探讨上海大学生非酒精性脂肪肝(NAFLD)的患病率及与载脂蛋白E(ApoE)基因多态性的相关性.方法 对上海同济大学4 148名在校学生进行问卷调查;采用肝脏超声以及血肝功能、脂蛋白等生化指标检测,将确诊的NAFLD患者与正常者200例,进行外周血PCR-RFLP检测ApoE基因多态性.结果 (1)4 148名大学生中NAFLD检出398例(9.6%),NAFLD患者的体重指数、腰臀比、甘油三酯、总胆固醇、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转移酶均高于对照组(P＜0.01),且随NAFLD程度加重,有递增趋势.(2)NAFLD组和对照组ApoE基因型分布比较差异显著(,P＜0.01).NAFLD E4/4基因型分布频率(5.5%)明显升高,E3/3分布频率(61.8%)明显减低(均P＜0.01).(3)非条件logistic回归分析显示总胆固醇、低密度脂蛋白胆固醇、腰臀比、AST、ALT、GGT与E4/4基因型密切相关.结论 ApoE基因112位和158位的氨基酸残基发生相应的变化可引起不同程度的脂质代谢障碍,E4/4可能是导致NAFLD发生的遗传因素之一.

Relationship between nonalcoholic fatty liver and apolipoprotein E gene polymorphism in undergraduate students of Shanghai

Objective To explore the relationship between nonalcoholic fatty liver (NFALD)and apolipoprotein E (ApoE)gene polymorphism in Shanghai undergraduate students. Methods A cross-sectional survey was performed in 4 148 students from Shanghai Tongji University. Quesgionary, physical measurement, ultrasonography and biochemical parameters were used to diagnose NFALD. In patients with NAFLD and 200 healthy subjects (served as control), ApoE genotypes were determined by PCR-RFLP. Results (1)Totally 398 subjects were diagnosed as NAFLD (prevalence 9.6%). Body mass index, waist-to-hip ratio, triglycerides, total cholesterol, alanine transaminase, aspartate aminotransferase and γ-glutamyltransferase in NAFLD group were higher than those in control, which were related to the degree of NAFLD (P＜0.01). (2)ApoE genotypes distributions were significantly different between two groups (χ2=10.52, P＜0.01). In NAFLD,E4/4 genotype frequency (5.5%)increased, and E3/3 (61.8%)decreased . (3)Unconditional logistic regression showed that E4/4 were closely associated with lipid profiles. Conclusion ApoE point mutations 112 and 158 may cause different dyslipidosis. E4/4 genotype seems to be one of the genetic predisposition factors of NAFLD.