血清生长分化因子15与代谢相关脂肪性肝病患者糖脂代谢的关联性研究  

Associations between serum GDF15 and glycolipid metabolism disorder in metabolic associated fatty liver patients

作　　者：李雪[1,2] 于雪梅 李恩浩 陈培红 郑丽妹 张珊 Li Xue;Yu Xuemei;Li Enhao;Chen Peihong;Zheng Limei;Zhang Shan(Anhui University of Science and Technology,Huainan 232001,China;Department of Endocrinology and Metabolism,Fengxian District Central Hospital,Shanghai 201406,China;The Third School of Clinical Medicine,Southern Medical University,Guangzhou 510630,China)

机构地区：[1]安徽理工大学,淮南232001 [2]上海市奉贤区中心医院内分泌代谢科,上海201406 [3]南方医科大学第三临床医学院,广州510630

出　　处：《中华内科杂志》2023年第8期987-992,共6页Chinese Journal of Internal Medicine

基　　金：上海市卫生和计划生育委员会科研课题(202040182);上海市奉贤区科委社会类科技发展基金(20211806)。

摘　　要：目的:探索血清生长分化因子15(GDF15)在代谢相关脂肪性肝病(MAFLD)患者中与糖脂代谢的关系。方法:横断面研究。纳入2020年2月至2021年2月奉贤区中心医院体检人群333例。其中,MAFLD合并2型糖尿病(T2DM)组107例,男54例、女53例,年龄(57±11)岁;单独T2DM组105例,男53例、女52例,年龄(56±10)岁;单独MAFLD 65例,男32例、女33例,年龄(49±5)岁;56例无脂肪肝且无糖尿病的健康体检者作为对照组,男28名、女28名,年龄(48±6)岁。采用酶联免疫吸附法测定血清GDF15水平。运用IBM SPSS 26.0进行统计学分析,使用logistic回归评估GDF15与MAFLD患者代谢异常的关联。结果:GDF15在对照组[385(296,484)ng/L]、MAFLD非肥胖组[388(319,435)ng/L]、MAFLD超重/肥胖组[426(354,527)ng/L]、T2DM组[664(483,900)ng/L]、MAFLD合并T2DM组[770(560,1074)ng/L]中依次升高(H=113.82,P=0.001);血清GDF15在单独MAFLD组[406(339,524)ng/L]与对照组中差异无统计学意义(U=1505.50,P=0.132)。然而,MAFLD合并T2DM组显著高于单独T2DM组(U=4573.50,P=0.019)。logistic回归分析发现,随着血清GDF15水平升高,出现单独MAFLD(OR=2.202)、T2DM(OR=29.656)、MAFLD合并T2DM(OR=58.197)的风险依次升高。血清GDF15在MAFLD患者FIB4指数(FIB4)>1.45组[773(534,1162)ng/L]高于FIB4<1.45组[527(389,787)ng/L](U=1709.50,P<0.001);随着血清GDF15水平升高,进展性肝纤维化(OR=2.388)的风险升高。结论:单独MAFLD患者血清GDF15水平与对照组比较差异无统计学意义,T2DM、MAFLD合并T2DM患者GDF15水平较对照组显著升高;血清GDF15水平越高,出现MAFLD合并糖脂代谢异常的风险越大、程度越重;高水平的GDF15增加了MAFLD进展性纤维化的风险。ObjectiveTo investigate relationships between serum growth differentiation factor 15(GDF15)and glycolipid metabolism in patients with metabolic associated fatty liver disease(MAFLD).MethodsThe current investigation was a cross-sectional study.A total of 333 patients from the Fengxian District Central Hospital were recruited into the study after physical examination from February 2020 to February 2021.There were 107 patients with MAFLD and type 2 diabetes mellitus(T2DM),including 54 males and 53 females with a mean age of(57±11)years.There were 65 patients with simple MAFLD only,including 32 men and 33 women with a mean age of(49±5)years.There were 105 patients with T2DM only,including 53 men and 52 women,with a mean age of(56±10)years.A control group of 56 people without MAFLD or diabetes,28 male,28 female,mean age(48±6)years,was also included in the study.Serum GDF15 was measured via enzyme-linked immunosorbent assays.IBM SPSS 26.0 was used for statistical analysis.Logistic regression was used to evaluate relationships between GDF15 and metabolic abnormalities in MAFLD patients.ResultsGDF15 progressively increased in the control[385(296,484)ng/L],nonobese MAFLD[388(319,435)ng/L],obese MAFLD[426(354,527)ng/L],T2DM[664(483,900)ng/L],and MAFLD+T2DM groups[770(560,1074)ng/L](H=113.82,P=0.001).There was no significant difference in serum GDF15 between the simple MAFLD[406(339,524)ng/L]and control group(U=1505.50,P=0.132).GDF15 was significantly higher in the MAFLD+T2DM group than in the T2DM-only group(U=4573.50,P=0.019).In logistic regression analysis increased GDF15 was associated with increased risks of simple MAFLD[odds ratio(OR)=2.202],T2DM(OR=29.656),and MAFLD+T2DM(OR=58.197).In patients with MAFLD,serum GDF15 was higher in the FIB4 index>1.45 group[773(534,1162)ng/L]than in the FIB4 index<1.45 group[527(389,787)ng/L](U=1709.50,P<0.001).Increased GDF15 was associated with an increased risk of advanced liver fibrosis(OR=2.388).ConclusionIn patients with simple MAFLD,GDF15 level was not significantly higher t

关 键 词：脂肪肝 生长分化因子15 代谢疾病 

分 类 号：R575.5[医药卫生—消化系统]