非酒精性脂肪肝炎患者Hcy水平与C-IMT预测心血管病风险的相关性  

Correlation between homocysteine level and carotid artery intima-media thickness in patients with nonalcoholic steatohepatitis

作　　者：王仁萍[1] 郭佳佳[2] 王伟[1] 刘洁[3] 张媛媛[3] 

机构地区：[1]青岛大学附属医院健康查体中心,山东省青岛市266003 [2]淄博市中心医院干部保健科,山东省淄博市255000 [3]青岛大学医学院老年医学教研室,山东省青岛市266003

出　　处：《世界华人消化杂志》2016年第5期775-781,共7页World Chinese Journal of Digestology

摘　　要：目的:本研究的目的是探讨非酒精性脂肪肝炎患者同型半胱氨酸(homocysteine,Hcy)水平与颈动脉内-中膜厚度(carotid artery intimae-media thickness,C-IMT)预测的心血管病风险之间的相关关系.方法:选取肝脏活检证实的80例非酒精性脂肪性肝炎(nonalcoholic fatty hepatitis,NASH)组、80例单纯性脂肪肝患者(non-alcoholic fatty liver,NAFL)组和50名健康对照者(CONTROL组),测量3组患者的血脂、肝脏生化指标、Hcy、C-IMT预测的心血管病风险之间进行相关性分析.结果:NASH组和NAFL组血清Hcy水平较CONTROL组均有升高,且有统计学意义;其中NASH组血清Hcy水平较NAFL组升高,有统计学意义.由此表明,Hcy升高为非酒精性脂肪肝病所共有,但与NAFL组相比较,其对NASH组影响更显著;相关性分析显示:C-IMT与体质量指数(body mass index,BMI)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、谷草转氨酶(aspartate transaminase,AST)、Hcy呈正相关,C-IMT的逐步多元线性回归分析显示:NASH、高血压、代谢综合征(metabolic syndrome,MS)、Hcy为C-IMT的危险因素(标准回归系数分别是1.515、2.066、3.270、1.240,P值分别是0.001、0.032、0.009、0.039).结论:NASH患者Hcy水平与C-IMT预测的心血管病风险之间存在正相关,可作为心血管风险的独立危险因子.AIM： To evaluate the relationship between carotid artery intimae-media thickness（C-IMT） and plasma homocysteine（Hcy） level in nonalcoholic fatty hepatitis（NASH） patients.METHODS： Eighty patients with NASH proven by liver biopsy, 80 patients with nonalcoholic fatty liver（NAFL） and 50 healthy controls were included. Blood lipids, liver biochemical indexes, serum homocysteine and carotid artery intimae-media thickness were measured and analyzed by correlation analysis. RESULTS： In the NASH group, Hcy level was significantly higher in the NASH and NAFL groups than in the control group（P〈0.05）, and in the NASH group than in the NAFL group. Correlation analysis showed that C-IMT was positively correlated with body mass index（BMI）, total cholesterol（TC）, triacylglycerol（TG）, aspartate transaminase（AST） and Hcy.Multiple linear regression analysis showed that NASH, hypertension, metabolic syndrome（MS）, and Hcy were risk factors for C-IMT（standardized regression coefficients = 1.515, 2.066, 3.270, and 1.240; P = 0.001, 0.032, 0.009, and 0.039, respectively）. CONCLUSION： Hey levels in patients with non-alcoholic fatty hepatitis are closely related to C-IMT and could be a risk factor for cardiovascular disease.

关 键 词：非酒精性脂肪肝炎 同型半胱氨酸 颈动脉内-中膜厚度 心血管疾病 

分 类 号：R575[医药卫生—消化系统]