超重人群中健康者与非酒精性脂肪性肝病患者的临床特征及血清脂质组学分析  

Clinical features and serum lipidomic profile of patients with nonalcoholic fatty liver disease and healthy individuals in the overweight population

作　　者：陈小燕[1] 袁乙富 杜晟楠 曹勤[1] 蒋元烨[1] CHEN Xiaoyan;YUAN Yifu;DU Shengnan;CAO Qin;JIANG Yuanye(Department of Gastroenterology,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)

机构地区：[1]上海中医药大学附属普陀医院消化内科,上海200062

出　　处：《临床肝胆病杂志》2024年第2期284-291,共8页Journal of Clinical Hepatology

基　　金：上海市自然科学基金(22ZR1455900);上海市卫健委临床研究专项面上项目(201940449);上海市普陀区卫生健康系统科技创新项目重点项目(ptkwws202201);上海中医药大学后备卓越中医人才项目(20D-RC-02);上海市名中医沈红权普陀传承工作室(ptzygzs2201,SHGZS-202224);上海市普陀区杏林优青人才培养计划(ptxlyq2201)。

摘　　要：目的探究超重人群中,非酒精性脂肪性肝病(NAFLD)患者与健康人的临床指标与脂质代谢差异。方法本研究将体质量指数(BMI)>23 kg/m^(2)定义为超重人群,选取2020年8月—2021年4月上海中医药大学附属普陀医院收治的62例超重NAFLD患者纳入超重NAFLD组,另选取同期超重健康体检者50例作为对照。记录所有受试者的临床信息以及血液生化指标数据。应用超高效液相色谱-串联质谱法(UPLC-MS/MS)进行血清脂质组学分析;使用主成分分析法和正交偏最小二乘法判别分析对脂质组学数据进行多元统计分析。计数资料两组间比较采用χ^(2)检验。计量资料两组间比较采用成组t检验或Wilcoxon秩和检验。结果超重NAFLD组BMI显著高于超重对照组(Z=-2.365,P=0.018)。血清学指标中,超重NAFLD组红细胞、血红蛋白、红细胞比容、尿酸、总蛋白、球蛋白、ALP、GGT、ALT、AST、胆碱酯酶、低密度脂蛋白、总胆固醇、甘油三酯、载脂蛋白B、血糖水平均显著高于超重对照组(P值均<0.05)。脂质组学分析结果显示两组间脂质代谢具有明显差异,共鉴定出差异性脂质(VIP值>1,P<0.05)493个,其中超重NAFLD组中有143个脂质显著上调,350个脂质显著下调。超重NAFLD组的平均脂肪酸总量是超重对照组的3.6倍。超重NAFLD组不饱和键数>3的甘油三酯含量较超重对照组降低(P<0.001),而不饱和键数≤3的甘油三酯含量较超重对照组增多(P<0.001)。结论超重NAFLD患者的部分生化指标及脂质代谢产物明显异于超重健康人,血液内脂肪酸明显升高,甘油三酯中的含饱和脂肪链的种类显著升高。objective To investigate the differences in clinical indices and lipid metabolism between the patients with nonalcoholic fatty liver disease(NAFLD)and healthy individuals in the overweight population.Methods In this study,body mass index(BMI)>23 kg/m^(2) was defined as overweight.A total of 62 overweight patients with NAFLD who were admitted to Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2020 to April 2021 were enrolled as overweight NAFLD group,and 50 overweight individuals who underwent physical examination during the same period of time were enrolled as control group.Clinical information and blood biochemical parameters were recorded for all subjects.Ultra-performance liquid chromatography-tandem mass spectrometry was used to analyze serum lipidomic profile,and principal component analysis and orthogonal partial least squares-discriminant analysis were used to perform the multivariate statistical analysis of lipidomic data.The chi-square test was used for comparison of categorical data between two groups,and the independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups.Results The overweight NAFLD group had a significantly higher BMI than the overweight control group(Z=−2.365,P=0.018).As for serological markers,compared with the overweight control group,the overweight NAFLD group had significantly higher levels of red blood cells,hemoglobin,hematocrit,uric acid,total protein,globulin,alkaline phosphatase,gamma-glutamyl transpeptidase,alanine aminotransferase,aspartate aminotransferase,cholinesterase,low-density lipoprotein,total cholesterol,triglyceride,apolipoprotein B,and blood glucose(all P<0.05).The lipidomic analysis showed that there was a significant difference in lipid metabolism between the two groups,and a total of 493 differentially expressed lipids were identified(VIP value>1,P<0.05),among which 143 lipids were significantly upregulated and 350 lipids were significantly downregulated in t

关 键 词：非酒精性脂肪性肝病 超重 体征和症状 脂质组学 

分 类 号：R575.5[医药卫生—消化系统]