血管生成素样蛋白8与Hp阳性肥胖患儿并发NAFLD的关系  

Relationship Between Angiopoietin-like Protein 8 and NAFLD in Hp Positive Obese Children

作　　者：白青山[1] 宋鹏[2] 于艳 高慧[3] Bai Qingshan;Song Peng;Yu Yan(Tangshan Maternal and Child Health Hospital,Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院消化内科,063000 [2]唐山市妇幼保健院儿内科,063000 [3]唐山市妇幼保健院内科,063000

出　　处：《医学研究杂志》2021年第5期71-75,共5页Journal of Medical Research

基　　金：河北省医学科学研究基金资助项目(20201487)。

摘　　要：目的探究血管生成素样蛋白8(angiopoietin-like protein 8,ANGPTL8)与幽门螺杆菌(Helicobacter pylori,Hp)阳性肥胖患儿并发非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的关系。方法选择2019年1月~2020年5月在唐山市妇幼保健院就诊的402例Hp阳性肥胖患儿作为研究对象。根据是否合并NAFLD将其分为2组,即单纯肥胖组(n=123)和肥胖合并NAFLD组(n=279)。另择100例年龄、性别与之匹配的健康儿童作为对照组。采用酶联免疫吸附法检测血浆ANGPTL8水平,并分析其与NAFLD的关系。结果肥胖合并NAFLD组ANGPTL8水平为26.31±3.25ng/ml,高于单纯肥胖组(22.26±2.28ng/ml)和对照组(19.59±5.11ng/ml),差异均有统计学意义(P<0.05)。限制性立方样条拟合Logistic回归分析结果显示ANGPTL8与Hp阳性肥胖患儿并发NAFLD有关,呈非线性关系(P<0.05)。Lasso回归分析结果显示,体重指数(body mass index,BMI)、空腹血糖(fasting blood glucose,FBG)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)和ANGPTL8均是Hp阳性肥胖患儿并发NAFLD的独立危险因素(P<0.05)。由FBG、TC、LDL-C、ALT、AST和ANGPTL8构建的列线图回归模型的拟合曲线与理想曲线重合度高,C-index为0.971。结论高水平ANGPTL8的Hp阳性肥胖患儿并发NAFLD风险高。基于ANGPTL8构建的列线图回归模型有较高的区分度和精准度,可有效预判Hp阳性肥胖患儿并发NAFLD。Objective To explore the relationship between angiopoietin-like protein 8(ANGPTL8)and Helicobacter pylori(Hp)positive obese children complicated with non-alcoholic fatty liver disease(NAFLD).Methods A total of 402 children with Hp positive obesity who visited Tangshan Maternal and Child Health Hospital from January 2019 to May 2020 were selected as study subjects.According to whether combined with NAFLD,they were divided into two groups:simple obese group(n=123)and obese combined with NAFLD group(n=279).Another 100 healthy children with matching age and gender were selected as the control group.The level of plasma ANGPTL8 was detected by enzyme-linked immunosorbent assay,and its relationship with NAFLD was analyzed.Results The level of ANGPTL8 in the obese combined with NAFLD group was 26.31±3.25ng/ml,which was higher than that in the simple obese group(22.26±2.28ng/ml)and the control group(19.59±5.11ng/ml),and the differences were statistically significant(P<0.05).Restricted cubic spline fitting Logistic regression analysis showed that ANGPTL8 was associated with NAFLD in Hp positive obese children,showing a non-linear relationship(P<0.05).The results of lasso regression analysis showed that body mass index(BMI),fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and ANGPTL8 were independent risk factors for NAFLD in Hp positive obese children(P<0.05).The fitting curve of the regression model of the nomogram constructed by FBG,TC,LDL-C,ALT,AST and ANGPTL8 had a high degree of coincidence with the ideal curve,and the C-index was 0.971.Conclusion Hp positive obese children with high levels of ANGPTL8 have a high risk of NAFLD.The nomogram regression model based on ANGPTL8 has a high degree of discrimination and accuracy,and can effectively predict the incidence of NAFLD in Hp positive obese children.

关 键 词：非酒精性脂肪性肝病 幽门螺杆菌 肥胖 血管生成素样蛋白8 

分 类 号：R725.7[医药卫生—儿科]