成年人群中血清铁蛋白与单纯性脂肪肝和脂肪性肝炎的关系  

ASSOCIATION BETWEEN SERUM FERRITIN LEVELS AND NONALCOHOLIC FATTY LIVER DISEASE AND STEOTOHEPATITIS IN ADULTS

作　　者：赵恩光 黄礼妍 许海燕 刘莉[2] 张卿[2] 宋崑[2] 牛凯军[2,3] ZHAO En-guang;HUANG Li-yan;XU Hai-yan;LIU Li;ZHANG Qing;SONG Kun;NIU Kai-jun(Health Bureau of Beichen District,Tianjin 300400;Health Management Centre,Tianjin Medical University General Hospital,Tianjin 300052;Nutritional Epidemiology Institute and School of Public Health,Tianjin Medical University,Tiianjin 300070,China)

机构地区：[1]天津市北辰区疾病预防控制中心,天津300400 [2]天津医科大学总医院健康管理中心,天津300052 [3]天津医科大学公共卫生学院营养流行病学研究所,天津300070

出　　处：《营养学报》2020年第3期234-239,共6页Acta Nutrimenta Sinica

基　　金：天津市科技支撑计划重点项目(No.11ZCGYSY05700,12ZCZDSY20400,13ZCZDSY20200)。

摘　　要：目的评估血清铁蛋白与非酒精性脂肪肝(单纯性脂肪肝和脂肪性肝炎)之间的关联。方法本研究人群来自"天津人群慢性炎症与健康促进队列"研究,共有7186人纳入最终分析。血清铁蛋白浓度采用酶联免疫法测定,单纯性脂肪肝和脂肪性肝炎通过肝脏超声检查和血清ALT来诊断。采用多因素Logistic回归模型评估血清铁蛋白水平与单纯性脂肪肝和脂肪性肝炎患病风险之间的关联。结果在调整混杂因素后,血清铁蛋白水平四分位组从低到高,单纯性脂肪肝和脂肪性肝炎的比值比(95%置信区间)分别为:单纯性脂肪肝:1.00 (参照组)、1.12 (0.93, 1.34)、1.37 (1.15,1.64)、1.58 (1.32, 1.88),血清铁蛋白水平与单纯性脂肪肝呈显著正相关(趋势性P <0.0001);脂肪性肝炎:1.00 (参照组)、1.68 (1.14, 2.50)、2.73 (1.90, 3.98)、5.21 (3.67, 7.50),血清铁蛋白与脂肪性肝炎之间关联具有统计学意义(趋势性P <0.0001),这种关联在经过性别分层后仍然存在。结论该研究表明在成年人群中,血清铁蛋白水平与单纯性脂肪肝和脂肪性肝炎独立相关。需要进一步的研究证实铁蛋白在单纯性脂肪肝和脂肪性肝炎发病过程中的预测价值。[营养学报,2020,42(3):234-239]Objective To investigate the association between serum ferritin levels and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Methods Participants were recruited from "Tianjin chronic low-grade systemic inflammation and health(TCLSIHealth) Cohort Study". A total of 7186 adults were included in final analyses. Serum ferritin was measured using Enzyme-linked immunoassay, while simple fatty liver disease and nonalcoholic steatohepatitis were diagnosed based on liver ultrasonography and the measurement of serum alanine aminotransferase. Multivariate logistic regression analysis was used to examine the association between the quartiles of serum ferritin and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Results After adjusting for potential confounding factors, the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis were significantly increased in accordance with the quartiles of serum ferritin and the odds ratios(95% confidence interval) were: simple fatty liver disease, 1.00(reference), 1.12(0.93, 1.34),1.37(1.15, 1.64),1.58(1.32, 1.88). There was a significant positive correlation between serum ferritin level and simple fatty liver(P for trend <0.0001);nonalcoholic steatohepatitis, 1.00(reference), 1.68(1.14, 2.50),2.73(1.90, 3.98),5.21(3.67, 7.50). The correlation between serum ferritin and steatohepatitis was statistically significant(P for trend <0.0001), and this association remained significant after sex stratification. Conclusion The study suggested that elevated ferritin levels were significantly related to the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Further study is needed to determine whether ferritin has a predictive role in the occurrence of nonalcoholic fatty liver disease.[ACTA NUTRIMENTA SINICA, 2020,42(3):234-239]

关 键 词：铁蛋白 脂肪肝 炎症 成年人 横断面研究 

分 类 号：R181.37[医药卫生—流行病学]