Abstract：
This study aimed to determine whether obese men with nonalcoholic fatty liver disease (NAFLD) display differences between those with simple steatosis versus steatohepatitis (NASH) in splanchnic and hepatic FFA and VLDL-triglycerides (VLDL-TG) balances. The study involved 17 obese men with biopsy-proven NAFLD (9 with NASH and 8 with simple steatosis). We used hepatic vein catheterization in combination with [3H]palmitate and [14C]VLDL-TG tracers to measure splanchnic palmitate and VLDL-TG uptake and release rates during basal and hyperinsulinemic conditions. Indocyanine green was used to measure splanchnic plasma flow. Splanchnic palmitate uptake was similar in the two groups and significantly reduced during hyperinsulinemia (NASH: 62 (48-77) versus 38 (18-58) μmol/min; simple steatosis: 62 (46-78) versus 45 (25-65) μmol/min, mean (95% CI), basal versus clamp periods, respectively, P = 0.02 time-effect). Splanchnic palmitate release was also comparable between groups and nonsignificantly diminished during hyperinsulinemia. The percent palmitate delivered to the liver originating from visceral adipose tissue lipolysis was similar and unchanged by hyperinsulinemia. Splanchnic uptake and release of VLDL-TG were similar between groups. Hyperinsulinemia suppressed VLDL-TG release (P <0.05 time-effect) in both groups. Insulin-mediated glucose disposal was similar in the two groups (P = 0.54). Obese men with NASH and simple steatosis have similar splanchnic uptake and release of FFA and VLDL-TG and a similar proportion of FFA from visceral adipose tissue lipolysis delivered to the liver. These results demonstrate that the splanchnic balances of FFA and VLDL-TG do not differ between obese men with NASH and those with simple steatosis.
摘要：
这项研究旨在确定患有非酒精性脂肪性肝病（NAFLD）的肥胖男性与单纯脂肪变性患者之间是否存在差异内脏和肝FFA和VLDL-甘油三酯（VLDL-TG）平衡中的脂肪性肝炎（NASH）。该研究涉及17名患有活检证实的NAFLD的肥胖男性（9名患有NASH，8名患有单纯脂肪变性）。我们将肝静脉导管插入术与[3H]棕榈酸酯和[14C]VLDL-TG示踪剂结合使用，以测量基础和高胰岛素血症期间内脏棕榈酸酯和VLDL-TG的摄取和释放率。吲哚菁绿用于测量内脏血浆流量。两组的内脏棕榈酸摄取相似，在高胰岛素血症期间显着降低（NASH：62（48-77）与38（18-58）μmol/min；单纯脂肪变性：62（46-78）vs.45(25-65)μmol/min,平均值（95%CI），基底与钳位周期，分别,p=0.02时间效应)。在高胰岛素血症期间，内脏棕榈酸酯的释放在各组之间也具有可比性，并且没有显着减少。从内脏脂肪组织（VAT）脂解作用传递到肝脏的棕榈酸酯百分比相似，但由于高胰岛素血症而没有变化。两组内脏对VLDL-TG的摄取和释放相似。高胰岛素血症抑制了两组的VLDL-TG释放（p<0.05时间效应）。胰岛素介导的葡萄糖处置在两组间比拟相似(p=0.54)。结论：患有NASH和单纯性脂肪变性的肥胖男性内脏FFA和VLDL-TG的摄取和释放相似，来自VAT脂解的FFA的比例相似。这些结果表明，FFA和VLDL-TG内脏平衡不受NAFLD严重程度的影响。
