血清甘胆酸、总胆汁酸、胰高血糖素样肽-1在脂肪肝向肝癌转化中的意义及与机体糖脂代谢的关系探讨  

The significance of serum glycocholic acid,total bile acid and glucagon-like peptide-1 in the transformation of fatty liver to liver cancer and its relationship with body glucose and lipid metabolism

作　　者：喻茂文 汤洪波 陈建军[1] 柳建磊 Yu Maowen;Tang Hongbo;Chen Jianjun;Liu Jianlei(Department of Experimental Medicine,Jintang Hospital of West China Hospital of Sichuan University,Chengdu 610400,China;Tongchang Medical Laboratory,Chengdu 610000,China)

机构地区：[1]四川大学华西医院金堂医院实验医学科,成都610400 [2]成都同昌医学检验所,成都610000

出　　处：《中国医师进修杂志》2022年第4期314-318,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨血清甘胆酸(CG)、总胆汁酸(TBA)、胰高血糖素样肽-1(GLP-1)在脂肪肝向肝癌转化中的意义及与机体糖脂代谢的关系。方法选取2018年5月至2020年8月四川大学华西医院金堂医院收治的96例脂肪肝患者(脂肪肝组)、96例肝硬化患者(肝硬化组)及96例肝癌患者(肝癌组),并选取同期96例健康体检者作为健康对照组。比较各组一般资料、血清CG、TBA、GLP-1、糖化血红蛋白(HbA1c)、三酰甘油(TG)、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)水平,采用Pearson相关分析血清CG、TBA、GLP-1水平与机体糖脂代谢指标的相关性,并比较肝癌不同病理特征患者血清CG、TBA、GLP-1水平。结果脂肪肝组、肝硬化组、肝癌组血清CG、TBA、GLP-1、HbA1c均高于健康对照组[(3.57 ± 1.06)、(22.17 ± 8.44)、(31.44 ± 9.65) mg/L比(1.26 ± 0.78) mg/L,(5.94 ± 1.26)、(12.34 ± 4.02)、(20.65 ± 5.17) μmol/L比(2.87 ± 0.59) μmol/L,(8.34 ± 1.55)、(11.69 ± 3.26)、(17.84 ± 2.78) pmol/L比(6.68 ± 1.24) pmol/L,(5.52 ± 0.31)%、(5.89 ± 0.27)%、(6.11 ± 0.23)%比(5.11 ± 0.36)%],并且随病情演变加重,血清CG、TBA、GLP-1、HbA1c水平呈升高趋势,差异均有统计学意义(P<0.05)。肝硬化组、肝癌组TG、TC、HDL-C、LDL-C低于健康对照组和脂肪肝组,差异有统计学意义(P<0.05)。相关分析结果显示,血清CG、TBA、GLP-1与HbA1c呈正相关(P<0.05),与TG、TC、HDL-C、LDL-C呈负相关(P<0.05)。肝癌患者随着临床分期增加,血清CG、TBA水平呈递增趋势(P<0.05)。结论随着脂肪肝向肝癌转化,血清CG、TBA、GLP-1水平升高,且变化趋势与机体糖脂代谢关系密切,可为临床完善脂肪肝转归评价机制提供参考。Objective To investigate the significance of serum glycocholic acid(CG),total bile acid(TBA),and glucagon-like peptide-1(GLP-1)in the transformation of fatty liver to liver cancer and their relationship with the body′s glucose and lipid metabolism.Methods From May 2018 to August 2020,96 patients with fatty liver(fatty liver group),96 patients with liver cirrhosis(cirrhosis group)and 96 patients with liver cancer(liver cancer group)admitted to Jintang Hospital of West China Hospital of Sichuan University were selected.Ninety-six healthy physical examination patients were selected during the same period as the normal control group.Compared the general information,serum CG,TBA,GLP-1,glycosylated hemoglobin(HbA1c),triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)levels of each group.The correlation between serum CG,TBA,GLP-1 levels and the body′s glucose and lipid metabolism indicators were analyzed by Pearson correlation.The correlation between serum CG,TBA,GLP-1 and clinical stage were analyzed.Results The levels of serum CG,TBA,GLP-1,and HbA1c in the fatty liver group,cirrhosis group,liver cancer group were higher than those in the normal control group:(3.57±1.06),(22.17±8.44),(31.44±9.65)mg/L vs.(1.26±0.78)mg/L;(5.94±1.26),(12.34±4.02),(20.65±5.17)μmol/L vs.(2.87±0.59)μmol/L;(8.34±1.55),(11.69±3.26),(17.84±2.78)pmol/L vs.(6.68±1.24)pmol/L;(5.52±0.31)%,(5.89±0.27)%,(6.11±0.23)%vs.(5.11±0.36)%,and with the progression of the disease,the levels showed a rising trend,and the differences were statistically significant(P<0.05).The levels of TG,TC,HDL-C,LDL-C in the cirrhosis group and liver cancer group were lower than those in the normal control group and fatty liver group,the differences were statistically significant(P<0.05).The results of correlation analysis showed that serum CG,TBA,GLP-1 were positively correlated with HbA1c(P<0.05),and serum CG,TBA,GLP-1 were negatively correlated with TG,TC,HDL-C,and LDL-C(P<0.0

关 键 词：脂肪肝 肝肿瘤 胆汁酸类和盐类 胰高血糖素样肽-1 糖脂代谢 

分 类 号：R735.7[医药卫生—肿瘤] R575.5[医药卫生—临床医学]