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目的探讨促肾上腺皮质激素(ACTH)非依赖性库欣综合征患者不同部位脂肪组织炎症及纤维化程度。方法收集行后腹腔镜下肾上腺肿物切除术的ACTH非依赖性库欣综合征患者的肾脏周围及皮下脂肪组织,RT-PCR检测白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及基质金属蛋白酶-2(MMP-2)、金属蛋白酶类组织抑制剂1(TIMP1)、早期生长反应因子1(EGR1)及脂肪因子CCAAT增强子结合蛋白β(CEBPβ)、解耦联蛋白-1(UCP-1)、过氧化物酶体增殖物激活受体γ共激活因子1α(PGC1α)及细胞死亡介导的DNA碎片因子样受体a(CIDEA)m RNA的表达。结果 ACTH非依赖性库欣综合征患者肾周脂肪组织中CIDEA m RNA的表达显著高于皮下脂肪组织(P<0.05)。而脂肪因子CEBPβ、UCP-1及PGC1αm RNA的表达在肾脏周围脂肪及皮下脂肪组织中差异无统计学意义。皮下脂肪组织IL-6、TIMP1及EGR1 m RNA的表达显著高于肾脏周围脂肪组织(P<0.05)。肾周脂肪组织及皮下脂肪中TNF-α及MMP-2 m RNA的表达相似。结论库欣综合征患者的皮下脂肪组织中的炎症及纤维化程度高于肾脏周围脂肪。提示不同部位脂肪组织具有不同的生物学特性,长时间较高水平的皮质醇刺激可能导致皮下脂肪炎症。
Objective To investigate the degree of adipose tissue inflammation and fibrosis in different parts of adrenocorticotropic hormone (ACTH) -induced Cushing’s syndrome. Methods Peripheral and subcutaneous adipose tissue were collected from patients with ACTH-independent Cushing’s syndrome after laparoscopic adrenalectomy. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF) -α) and MMP-2, TIMP1, EGR1, and CEAβbeta, and decoupling (UCP-1), peroxisome proliferator activated receptor γ coactivator 1α (PGC1α) and cell death-mediated DNA fragmentation-like receptor a (CIDEA) m RNA. Results The expression of CIDEA m RNA in perirenal adipose tissue of ACTH-independent Cushing’s syndrome patients was significantly higher than that of subcutaneous adipose tissue (P <0.05). However, the expression of adiponectin CEBPβ, UCP-1 and PGC1αmRNA were not statistically different between perirenal adipose tissue and subcutaneous adipose tissue. The expression of IL-6, TIMP1 and EGR1 m RNA in subcutaneous adipose tissue was significantly higher than that in perivascular adipose tissue (P <0.05). The expressions of TNF-α and MMP-2 m RNA in perirenal adipose tissue and subcutaneous fat were similar. Conclusion The subcutaneous adipose tissue in Cushing’s syndrome patients have higher degree of inflammation and fibrosis than the perirenal fat. Suggesting different parts of adipose tissue has different biological characteristics, prolonged high levels of cortisol may lead to subcutaneous fat inflammation.