Changes in intestinal flora in nonalcoholic fatty liver disease: their correlation with insulin resistance index, tumor necrosis factor-α, and interleukin-6

• Main Authors: ZHANG Qiunan, XIAO Ying, MIAO Ruixin
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2015-07-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=6640

Objective To explore the changes in intestinal flora in patients with nonalcoholic fatty liver disease (NAFLD) and their correlation with homeostatic model assessment-insulin resistance (HOMA-IR) index, serum tumor necrosis factor-α (TNFα), and interleukin-6 (IL-6). Methods Eighty-two patients with NAFLD who were diagnosed and treated in the Department of Gastroenterology in our hospital from January 2013 to September 2014 were enrolled into NAFLD group. Sixty healthy physical examinees were used as controls. Fresh feces and fasting serum of all subjects were collected to calculate intestinal colonization resistance (B/E value) and HOMA-IR. The serum levels of TNFα and IL-6 were determined by enzyme-linked immunosorbent assay. The correlation of B/E value with HOMA-IR, TNFα, and IL-6 was analyzed. Between-group comparison of continuous data was performed by t test, and multiple-group comparison was performed by analysis of variance. Correlation analysis was made by Pearson correlation analysis. Results Compared with the control group, the NAFLD group had significantly decreased numbers of bifidobacteria and lactobacilli, significantly increased numbers of Enterobacteriaceae and Enterococcus, and a significantly lower B/E value (all P＜0.01). Moreover, the NAFLD group had significantly higher levels of serum alanine aminotransferase, aspartate aminotransferase, triglycerides, fasting plasma glucose, fasting serum insulin, HOMA-IR, TNFα, and IL-6 than the control group (all P＜0.01). Correlation analyses showed that B/E value was significantly negatively correlated with HOMA-IR, TNFα, and serum IL-6 (r=-0.872, P＜0.01; r=-0.461, P＜0.01; r=-0.523, P＜0.01). Conclusion The changes in intestinal flora are closely related to changes in HOMA-IR and levels of TNFα and IL-6 in patients with NAFLD, which suggest that the above factors may influence and interact with each other, contributing to the development and progression of NAFLD.