血清25-羟基维生素D水平与非酒精性脂肪性肝病患者肝脏纤维化风险的关系  

Association between serum 25-hydroxyvitamin D level and the risk of liver fibrosis in patients withnonalcoholic fatty liver disease

作　　者：余超[1] 陈利[1] 蔺红梅[1] 姜雨薇 汪丽清 林妙霞[1] Yu Chao;Chen Li;Lin Hongmei;Jiang Yuwei;Wang Liqing;Lin Miaoxia(Center for Health Examination,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院体检中心,广州510630 [2]中山大学附属第三医院神经内科,广州510630

出　　处：《新医学》2019年第1期32-36,共5页Journal of New Medicine

基　　金：广东省科技计划项目基金资助(2009B03081008);广东省自然科学基金(2016A030313201)

摘　　要：目的分析血清25-羟基维生素D [25(OH)D]与非酒精性脂肪性肝病(NAFLD患者肝脏纤维化风险的相关性。方法对587例NAFLD患者采用ELISA法检测血清25(OH)D浓度,并采用NAFLD纤维化评分(NFS)评估NAFLD患者纤维化风险(NFS≥-1.455定义为中-高纤维化风险)。Logistic回归模型用于分析25(OH)D浓度(四分位组)与NAFLD患者肝脏纤维化风险的关联程度。结果 587例NAFLD患者中根据NFS,340例为中-高肝脏纤维化风险患者,中-高肝脏纤维化风险组25(OH)D水平低于低肝脏纤维化风险组(Z=-3.263,P <0.001)。按照25(OH)D四分位数分组分析发现,最低四分位组(≤18.20 ng/ml)比最高四分位组(≥33.27ng/ml)NAFLD患者的肝脏纤维化风险增加1.62倍(OR=2.621,P <0.001);在调整NAFLD的传统风险因素后,这种风险差异仍有统计学意义(P=0.002)。结论低血清25(OH)D水平与NAFLD患者肝脏纤维化风险密切相关。Objective To explore the correlation between the serum level of 25-hydroxyvitamin D[ 25(OH)D] and the risk of liver fibrosis in patients with nonalcoholic fatty liver disease( NAFLD). Methods The serum levels of 25(OH)D in 587 NAFLD patients were quantitatively measured using ELISA kit. The risk of liver fibrosis was assessed by NAFLD fibrosis score( NFS; NFS ≥-1.455 was defined as middle-high risk of liver fibrosis). The association between serum 25(OH)D level( quartile group) and the risk of liver fibrosis was analyzed using the logistic regression model. Results Among 587 NAFLD patients, 340 patients were evaluated with a middle-high risk of liver fibrosis according to NFS. The serum levels of 25 (OH)D in patients with a middle-high risk of liver fibrosis were significantly lower compared with those in their counterparts with a low risk of liver fibrosis( Z=-3.263, P<0.001). According to the quartile grouping analysis of serum 25(OH)D level, the risk of liver fibrosis in the lowest quartile group(≤ 18.20 ng/ml) was increased by 1.62 times than that in the highest quartile group(≥ 33.27 ng/ml,OR=2.621,P < 0.001). The statistical significance still existed after the traditional risk factors of NAFLD were adjusted( P = 0.002). Conclusion A low serum level of 25(OH)D is closely correlated with high risk of liver fibrosis in NAFLD patients.

关 键 词：维生素D 非酒精性脂肪性肝病 纤维化 

分 类 号：R575[医药卫生—消化系统]