台灣中部地區非酒精性脂肪肝患者PPAR-γ基因多型性之研究

非酒精性脂肪肝疾病(NAFLD)已是目前世界共通的疾病，嚴重者會進展至肝硬化甚至肝癌，對身體的危害不容小覷，由於罹患NAFLD人口逐年增加，同時衍生的代謝症候群相關疾病，已嚴重影響人體健康並增加醫療成本。過氧化體增殖劑活化受體（peroxisome proliferator- activatived receptors，PPAR）是活化配體的轉錄因子，屬於核酸激素接受體的家族成員，參與多種代謝過程中的基因調控，有α，δ，γ 3種亞型，而PPARγ基因可轉譯成三個不同的mRNA：PPARγ1、PPARγ2與PPARγ3，其中PPARγ2主要是在脂肪肝的肝細胞調節脂肪生成與脂質堆積，然而有關非酒精性脂肪肝與PPARγ2之間的文獻報告不多，因此本研究的目的為探討非酒精性脂肪肝與PPARγ2基因多型性的相關性，並評估PPARγ2在非酒精性脂肪肝病患與體位測量、血液生化值的相關性。本研究以非酒精性脂肪肝病患為研究對象；健康成人為對照組，完成本研究的受測者共117人，其中非酒精性脂肪肝病患有46人(男性31人、女性15人)，對照組有71人(男性16人、女性55人)。分析結果顯示台灣中區非酒精性脂肪肝疾病Pro/Ala與Ala/Ala的盛行率為13.04%；非酒精性脂肪肝病患與對照者的PPARγ2 Pro12Ala基因多型性的基因型相似，均以攜帶Pro/Pro基因型為主，兩組之間基因型比較，無顯著性差異(p>0.05)，顯示PPARγ2 Pro12Ala基因多型性可能與增加非酒精性脂肪肝疾病的危險無關。同時以基因型為觀察對象，分析非酒精性脂肪肝疾病組Pro/Pro、Pro/Ala和Ala/Ala基因型與身體質量指數、腰臀比、總膽固醇、三酸甘油酯、血糖、高密度脂蛋白、低密度脂蛋白、肝功能之間均無顯著差異(P>0.05)。 本研究分析非酒精性脂肪肝疾病患者和對照組的體位測量與生化數據的相關性，結果顯示身體質量指數、腰臀比、肝功能(ALT)、血糖顯著高於對照組(p<0.05)；高密度脂蛋白顯著低於對照組(p<0.05)；而且腰臀比、肝功能(ALT)男性顯著高於女性(p<0.05)。 本研究分析結果，非酒精性脂肪肝疾病與PPARγ2 Pro12Ala基因多型性之間無顯著相關，然而卻與身體質量指數、腰臀比、高密度脂蛋白、血糖、肝功能(ALT)有顯著相關。

Nowaday worldwide applicable nonalcoholic fatty liver disease (NAFLD) alarns us not to neglect and ignore its fatalness by threateningour health with a chance to progress to liver cirrhosis and hepatocellular carcinoma. On the other hand, the incidence of NAFLD is increasing year by year. It is a metabolic disorder and it has serious influence on health if metabolic syndrome is present altogether. Peroxisome proliferators activated receptors (PPARs) , which belong to the nuclear receptor family of ligand-activated transcription factors, as gene regulator of various metabolic pathways. As it consists of three kinds of subtypes α,δ,γ, it can transcript three mRNA isoforms: PPARγ1,PPARγ2 and PPARγ3, Though PPARγ2 is a major regulators of adipogenesis and lipid accumulation in hepatocyte, the relationship between NAFLD and the PPARγ2 study literature are not so much available. With the aim to find out the association between NAFLD Vs PPARγ2 genes polymerphism , and correlation between role of P PARγ2 in NAFLD Vs anthropometric and blood biochemistry value in NAFLD. In this Study, NAFLD patients are assigned to as diseased group. There are 117 person in this study .Among there 46 patients with 31 male and 15 female are in diseased group. The control group contains 16 male and 55 female , altogether 71 person. Analysis result show that the prevance rate of Pro/Ala and Ala/Ala is 13.04% in Taiwan center. As the genotypes of PPARγ2 Pro12Ala polymorphism are similar in both NAFLD patient and control group, the genotype comparison is now mainly relying on carrying Pro/Pro genotype. After comparison, it shows that PPARγ2 Pro12Ala polymorphism may not concern with increasing the risk of NAFLD. At the same time, regarding genotype as the target of observation, analysis of NAFLD group Pro/Pro, Pro/Ala and the Ala/Ala genotype Vs body mass index(BMI) ,WHR(Waist to Hip Ratio) ,Total cholesterol ,Triglyceride,Glucose, high density lipoprotein (HDL) , low density lipoprotein(LDL) , aminotransferase also shows no significant differences (p> 0.05 ).After analysing of this study ,it shows statistically significant that BMI , WHR, ALT ,Glucose are higher in diseased group (p<0.05 ) and HDL in diseased group is lesser than controlled group. Another significant is WHR, ALT in male is higher than in female (p<0.05 ).The study analysis result show that no significantly associated between NAFLD and PPARγ2 Pro12Ala polymorphism, however is significantly associated between NAFLD and BMI ,WHR ,HDL ,Glucose and ALT.