老年非酒精性脂肪性肝病与维生素D水平的关系研究  

Investigation of relationship between vitamin D and nonalcoholic fatty liver disease in Chinese elderly

作　　者：郝瑞瑞[1] 王欢[1] 罗佳[1] 赵真[1] HAO Rui-rui;WANG Huan;LUO Jia(Medical Healthcare Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院医疗保健中心内科

出　　处：《临床和实验医学杂志》2019年第23期2473-2476,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金(编号:81771860);北京市保健委员会调研课题(编号:京17-16)

摘　　要：目的探讨老年非酒精性脂肪性肝病(NAFLD)与维生素D水平的关系。方法采用回顾性横断面调查研究方法,选取2015年1月至2017年3月首都医科大学附属北京友谊医院医疗保健中心内科收治的年龄为65~101岁的体检人群,共663例,将所有研究对象按年龄分层:65~70岁,70~75岁,75~80岁,80~85岁,85~90岁,≥90岁。根据非酒精性脂肪性肝病诊疗指南中的工作定义,将所有研究对象分为NAFLD(242例)和非NAFLD组(421例)。比较NAFLD组和非NAFLD组的血清25-羟维生素D水平,以及不同年龄组的NAFLD患病率及25-羟维生素D水平。结果随研究对象的年龄增高,NAFLD患病率逐渐降低,各年龄组间NAFLD患病率比较,差异具有统计学意义(P=0.002)。NAFLD和非NAFLD组人群的性别构成比、年龄、转氨酶(AST)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(h-CRP)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、人促甲状腺激素(TSH)水平比较,差异均无统计学意义(P>0.05)。NAFLD组的25-羟维生素D水平低于非NAFLD组,差异具有统计学意义(P<0.001)。结论老年人群随着年龄的增长,NAFLD的患病率呈下降趋势。老年NAFLD人群血清25-羟维生素D水平显著低于非NAFLD者,提示低水平维生素D是老年NAFLD的独立危险因素之一。Objective This study investigated the relationship between NAFLD and vitamin D levels in the elderly by retrospective cross-sectional survey.Methods The subjects were selected from the Internal Medicine Department Medical Healthcare Center,Beijing Friendship Hospital,Capital Medical University between January 2015 and March 2017.All 663 subjects receiving medial examination were more than 65 years old.According to the age,these subjects were divided into 65~70 years old,70~75 years old,75~80 years old,80~85 years old,85~90 years old,≥90 years old.NAFLD was diagnosed according to the working definition in the Guidelines for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease(2010 revision).All subjects were divided into NAFLD(including 242 cases)and non-NAFLD groups(including 421 cases)according to the result of ultrasound.The serum 25-hydroxyvitamin D level between the NAFLD group and the non-NAFLD group was compared.The prevalence of NAFLD and the difference in 25-hydroxyvitamin D levels were compared between among different age groups.Results Total 901 patients met the inclusion criteria,and 238 patients were excluded according to the exclusion criteria,and 663 subjects were eventually included into the present study,aged 65 to 101 years.The prevalence of NAFLD in different age group was compared and the results showed statistically significant differences(P=0.002),suggesting a different prevalence of NAFLD in different age groups.The levels of 25-hydroxyvitamin D in each age group showed no statistical difference(P=0.148).There were no significant differences in gender,age,AST,TC,HDL-C,LDL-C,UA,h-CRP,FT3,FT4,and TSH between the two groups(P>0.05).The level of 25-hydroxyvitamin D in the NAFLD group was lower than that in the non-NAFLD group(P<0.001).Conclusion The prevalence of NAFLD in the elderly population decreases with age.Serum 25-hydroxyvitamin D level in elderly NAFLD patients was significantly lower than those in non-NAFLD,suggesting that low vitamin D was one of the independent risk fact

关 键 词：非酒精性脂肪性肝病 维生素D 老年人 危险因素 

分 类 号：R57[医药卫生—消化系统]