Study On Relationship Between Nonalcoholic Fatty Liver Disease And Phospholipids And Phospholipase-A2

Object and backgroundWith the development of living condition and the changing of food ingredients, the occurrence of NAFLD (Nonalcoholic Fatty Liver Disease) increases year by year. In the United States, NAFLD has become one of the most common chronic liver disease, and the situations in Europe and Japan are similar. About 15-50% patients are found to be liver fibrosis and cirrhosis . So, the phenomenon is put more and more care and intensive study has been carried out.Hyperlipidemia, hyperglycemia, obesity are considered as the maincauses of NAFLD. Liver is of great importance in the process of lipid metabolism. With the function of synthesis, transportation and decomposition by liver cell, the lipid level keeps dynamic equilibrium. However, because of the disorder of lipid metabolism, the equilibrium of body lipid level is no longer kept; more fat is absorbed by liver cells, and the transportation and decomposition or oxidizing decrease, which results in the accumulation of fat in liver, i.e., fatty liver.The common clinic symptom of NAFLD is disordered metabolism of lipid. The lipid forms include TG (triglyceride), cholesterol, cholesteryl ester and phospholipids. Phospholipids is one of the form of lipid, and is one of the important substance to synthesize serum lipoprotein. In NAFLD patients, more cases of high TG and high cholesterol can be found. However, the change of blood phospholipids is seldom reported. In this dissertation, after the measurement on serum phospholipids content and phospholiase activity, and comparing with the parallel group, the change of blood phospholipids is determined and the factors leading to the change is discussed.Material and MethodologyThe study was carried out in two parts. All the specimens were chosen from the persons who had their healthy checking in medical checkingcenter of the First Affiliated Hospital of Zhejiang University since November and December, 2006 to March, 2007. The determination of NAFLD was according to the criterion stipulated by Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association. The patients who had past medical history of DM(diabetes mellitus), high blood pressure, or elder than 70, younger than 16 were excluded. At the same time, the virus type liver disease was also excluded. The parallel group consisted of healthy persons. The ingeta alcohol in one week is less than 40 grams. The excluding criteria was the same as the NAFLD group. The couples in two groups were matched according to their gender and age. The couple members were with the same gender.The NAFLD group consisted of 101 specimens, 84 male and 17 female. The parallel group was of the same structure. The enzyme method and some other cprresponding method were employed to measure the PL, TG TC, HDL-C, LDL-C, VLDL-C, FPG and hepatitis enzymes. Then, the height, weight and blood pressure were measured. Finally, the BMI was calculated.In Part-Two, the NAFLD group consisted of 40 specimens, 28 male and 12 female. The parallel group was of the same structure. The ELISA method and some other cprresponding method were employed tomeasure the LP-PLA2,TG, TC, HDL-C, LDL-C, VLDL-C, FPG and hepatitis enzymes. Then, the height, weight and blood pressure were measured. Finally, the BMI was calculated.The measured data were processed by the computer software of SPSS 10.0. All the results are presented in the form of x±s. The t test approach was used to compare the results of the parallel groups. The Pearson single factor analysis skill and Multivariant Stepwise Regression Approach were employed to do the correlation analysis.ResultPart-OneNAFLD group, compared with the control group, have higher weight, pumping blood pressure and protodiastole pressure, and the difference is of statistic significance. The NAFLD BMI is higher than the control group (P<0.05). The NAFLD biomarker such as ALT, AST, GGT, TC, TG, VLDL-C, FPG are all higher than the ones of control group, and the difference is of statistic significance (P<0.01). NAFLD AKP is higher the control group (P<0.05). NAFLD HDL-C and A/G are lower than the control group (P<0.01) and the difference is of statistic significant. NAFLD LDL-C is a little higher than the controlled group, however, thedifference has no statistic significant (P<0.01). NAFLD serum phospholipids 250.23±55.24 mg/dL vs control group 229.23±39.03 mg/dL, the difference is great (t=3.120, P<0.01).2 The level of phospholipids is in obviously proportion to the level of AST, GGT, TG, TC, VLDL-C, FPG, and the correlation factors are 0.331 0.696. 0.743. 0.800. 0.765. 0.344 respectively, P<0.01. The Multivariant regressed equation is:y=63.346+34.932X₁+8.917X₂-4.709X3+0.171X₄+11.280X₅y- phospholipidsX_1-TCX_2-TGX_3-JPGX_4-GGTX_5-VLDL-C Part-TwoThe NAFLD group serum LP-PLA2 is (333.42±141.83) ug/L, and the parallel group is (424.63±178.22) ug/L, the difference is obvious (t=-2.533, P<0.05).LP-PLA2 is only in negative proportion to A/G (r= -0.325, P<0.05), and has little relation with TG, TC, HDL-C, LDL-C, VLDL-C, FPG and hepatitis enzymes(P>0.05).Conclusions1 For the Nonalcoholic Fatty Liver Disease patient, it is found to be disordered in phospholipids metabolism, and the level of blood phospholipids increases. For the more, it is in proportion with the level ofTG,TC,and VLDL.2 For the Nonalcoholic Fatty Liver Disease patients, the activity of LP-PLA2 decreases. However, it is not so obviously in relationship with the level of blood lipid or hepatitis enzymes. The decrease of LP-PLA2 activity may be the reason for the increase of Phospholipids in blood.