网状蛋白1C与Hp阳性肥胖患儿并发非酒精性脂肪性肝病的关系  

Relationship between reticulin 1C and concurrent non-alcoholic fatty liver disease 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;GAO Hui(Department of Gastroenterology,Tangshan Maternal and Child Health Hospital,Tangshan 063000,Hebei,China;Department of Pediatric Internal Medicine,Tangshan Maternal and Child Health Hospital,Tangshan 063000,Hebei,China;Department of Internal Medicine,Tangshan Maternal and Child Health Hospital,Tangshan 063000,Hebei,China)

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

出　　处：《贵州医科大学学报》2021年第6期728-733,共6页Journal of Guizhou Medical University

基　　金：河北省医学科学研究基金项目(20201487)。

摘　　要：目的探究外周血单个核细胞中网状蛋白1C(RTN-1C)与幽门螺杆菌(Hp)阳性肥胖患儿并发非酒精性脂肪性肝病(NAFLD)的关系。方法选取确诊的Hp阳性肥胖患儿206例作为研究对象,根据是否并发NAFLD分为非NAFLD组(n=63)和NAFLD组(n=143),收集并比较2组患者年龄、性别、体质量指数(BMI)、疾病史、空腹血糖(FBG)、胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)及天门冬氨酸氨基转移酶(AST)等基线资料,采用B超检查判断NAFLD组患儿NAFLD的严重程度;抽取2组患儿空腹肘部静脉血10 mL,采用Ficoll密度梯度离心法分离外周血中单个核细胞,再采用蛋白质免疫印迹法检测单个核细胞中RTN-1C水平;采用多因素Logistic回归分析影响Hp阳性肥胖患儿并发NAFLD的相关因素,采用受试者工作特征曲线(ROC)评价RTN-1C诊断Hp阳性肥胖患儿并发NAFLD的效能,采用限制性立方样条拟合Logistic回归分析RTN-1C与Hp阳性肥胖患儿并发NAFLD的关系,用Spearman相关分析RTN-1C与NAFLD严重程度的关系。结果NAFLD组患儿FBG、FINS、HOMA-IR、TC、LDL-C、ALT及AST水平均高于非NAFLD组,差异均有统计学意义(P<0.05);NAFLD组患儿外周血RTN-1C水平低于非NAFLD组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示FBG、TC、LDL-C和ALT是Hp阳性肥胖患儿并发NAFLD的独立危险因素(P<0.05),RTN-1C是独立保护因素(P<0.05);限制性立方样条拟合Logistic回归分析结果显示RTN-1C与Hp阳性肥胖患儿并发NAFLD呈线性关系(非线性检验P>0.05);Spearman分析结果显示NAFLD患儿RTN-1C水平与NAFLD严重程度呈负相关关系(r=-0.671,P<0.05)。结论RTN-1C与Hp阳性肥胖患儿并发NAFLD有关,RTN-1C水平与NAFLD严重程度呈负相关关系。Objective To investigate the relationship between reticulin 1C(RTN-1C)in peripheral blood mononuclear cells and concurrent non-alcoholic fatty liver disease(NAFLD)in Helicobacter pylori(Hp)positive obese children.Methods A total of 206 children diagnosed with Hp positive obesity were divided into non-NAFLD group(n=63)and NAFLD group(n=143)based on whether with concurrent NAFLD or not.The age,gender,body mass index(BMI),disease history,fasting blood glucose(FBG),insulin(FINS),homeostasis model assessment of insulin resist(HOMA-IR),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and other baseline data of the two groups were collected and compared.B-mode ultrasound was adopted to determine the NAFLD severity in NAFLD group.10 mL of fasting elbow venous blood from two groups of children was extracted,and Ficoll density gradient centrifugation was adopted to separate peripheral blood mononuclear cells,and then western blotting was adopted to detect the level of RTN-1C in the children's mononuclear cells.Multivariate Logistic regression was adopted to analyze the factors that causing concurrent NAFLD in Hp positive obese children,the effectiveness of RTN-1C in diagnosing concurrent NAFLD in Hp positive obese children was evaluated by receiver operating characteristic curve(ROC),the relationship between RTN-1C and concurrent NAFLD in Hp positive obese children was analyzed by restricted cubic spline fitting Logistic regression,and the relationship between RTN-1C and NAFLD severity was analyzed by Spearman correlation.Results The levels of FBG,FINS,HOMA-IR,TC,LDL-C,ALT,and AST in the NAFLD group were higher than those in the non-NAFLD group,and the differences were statistically significant(P<0.05).The level of peripheral blood RTN-1C in the NAFLD group was lower than that in the non-NAFLD group,and the difference was statistically significant(P<0.05).Multivariate Logistic regressio

关 键 词：肥胖症 非酒精性脂肪性肝病 幽门螺杆菌 网状蛋白1C 外周血单个核细胞 严重程度 

分 类 号：R725.7[医药卫生—儿科]