METHODS: GLUT-5 and GLUT-2 protein levels were assessed on duodenal mucosa biopsies of 31 subjects divided into 2 groups based on ultrasound-defined NAFLD presence who underwent an upper gastrointestinal endoscopy.
RESULTS: Individuals with NAFLD exhibited increased duodenal GLUT-5 protein levels in comparison to those without NAFLD, independently of demographic and anthropometric confounders. Conversely, no difference in duodenal GLUT-2 abundance was observed amongst the two groups. Univariate correlation analyses showed that GLUT-5 protein levels were positively related with body mass index, waist circumference, fasting and 2 h post-load insulin concentrations, and insulin resistance (IR) degree estimated by homeostatic model assessment of IR (r = 0.44; p = 0.02) and liver IR (r = 0.46; p = 0.03) indexes. Furthermore, a positive relationship was observed between duodenal GLUT-5 abundance and serum uric acid concentrations (r = 0.40; p = 0.05), a product of fructose metabolism implicated in NAFLD progression. Importantly, duodenal levels of GLUT-5 were positively associated with liver fibrosis risk estimated by NAFLD fibrosis score.
CONCLUSIONS: Increased duodenal GLUT-5 levels are associated with NAFLD and liver fibrosis. Inhibition of intestinal GLUT-5-mediated fructose uptake may represent a strategy for prevention and treatment of NAFLD.
方法:对31例接受上消化道内镜检查的患者进行十二指肠粘膜活检,根据超声定义的NAFLD存在情况分为2组,对GLUT-5和GLUT-2蛋白水平进行评估。
结果:与没有NAFLD的人相比,患有NAFLD的人表现出十二指肠GLUT-5蛋白水平升高,独立于人口统计学和人体测量学混杂因素。相反,两组十二指肠GLUT-2丰度无差异.单因素相关分析显示GLUT-5蛋白水平与体重指数呈正相关,腰围,空腹和负荷后2小时胰岛素浓度,通过稳态模型评估IR(r=0.44;p=0.02)和肝脏IR(r=0.46;p=0.03)指标来估计胰岛素抵抗(IR)程度。此外,十二指肠GLUT-5丰度与血尿酸浓度呈正相关(r=0.40;p=0.05),与NAFLD进展有关的果糖代谢产物。重要的是,十二指肠GLUT-5水平与NAFLD纤维化评分估计的肝纤维化风险呈正相关.
结论:十二指肠GLUT-5水平升高与NAFLD和肝纤维化相关。肠GLUT-5介导的果糖摄取的抑制可以代表预防和治疗NAFLD的策略。