催乳素水平降低在内分泌科住院的绝经女性非酒精性脂肪性肝病发生中的作用分析  

Analysis of the role of reduced prolactin levels in the occurrence of NAFLD in postmenopausal women hospitalized in the department of endocrinology

作　　者：徐萍 毕艳[1] 朱烨 张芃子 Xu Ping;Bi Yan;Zhu Ye;Zhang Pengzi(Department of Endocrinology,Drum Tower Hospital affiliated to Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院内分泌科,南京210008

出　　处：《国际内分泌代谢杂志》2024年第2期78-82,共5页International Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金重点项目(82030026);南京鼓楼医院临床研究专项资金项目(培育项目, 2021-LCYJ-PY-38)。

摘　　要：目的探讨催乳素(PRL)在内分泌科住院的绝经女性非酒精性脂肪性肝病(NAFLD)发生中的中介效应。方法回顾性分析2016年4月至2022年2月在南京大学医学院附属鼓楼医院内分泌科就诊的女性患者的临床资料, 根据纳排标准, 最终纳入2 399例。以停经≥12个月为绝经的诊断标准, 分为未绝经组(n=705)和绝经后组(n=1 694);根据患者腹部超声结果诊断是否患有NAFLD。空腹抽血检测糖化血红蛋白、血糖、血脂、肝酶、催乳素及雌二醇等性激素水平。结果绝经后组较未绝经组NAFLD患病率更高(42.6%比29.4%, P<0.001)。绝经后组血清催乳素水平显著低于未绝经组[6.8(5.0, 9.4) μg/L比11.3(8.5, 15.8) μg/L, P<0.001]。多因素logistic回归分析示, 绝经是女性NAFLD的危险因素(OR 2.278, 95%CI 1.551~3.347, P<0.001), 血清催乳素是NAFLD的保护因素(OR 0.944, 95%CI 0.921~0.968, P<0.001)。中介分析显示, 血清催乳素在女性绝经与NAFLD发生间起部分中介作用, 中介效应占比为36.88%。结论在内分泌科住院女性患者中, 血清催乳素水平下降可能介导了绝经后NAFLD的发生。Objective To explore the mediating effect of prolactin(PRL)on menopausal status and non-alcoholic fatty liver disease(NAFLD)in women hospitalized in the Department of Endocrinology.Methods According to the inclusion criteria,a total of 2399 female patients who hospitalized in the Endocrinology Department of Drum Tower Hospital affiliated to Nanjing University Medical School from April 2016 to February 2022 were retrospectively analyzed.Menopause is defined as 12 months of amenorrhea in women.Patients were classified into premenopausal group(n=705)and postmenopausal group(n=1694).Abdominal ultrasonography was used to diagnose NAFLD.All patients′fasting blood samples were collected for the HbA1c,blood glucose,blood lipids,liver enzymes,PRL,estradiol,and other sex hormone measurements.Results The prevalence of NAFLD was higher in the postmenopausal group than in the premenopausal group(42.6%vs.29.4%,P<0.001).Compared with those in the premenopausal group,serum PRL levels of patients were lower in the postmenopausal group[6.8(5.0,9.4)μg/L vs.11.3(8.5,15.8)μg/L,P<0.001].Multivariate logistic regression analysis indicated that the postmenopausal state was a risk factor for NAFLD(OR 2.278,95%CI 1.551-3.347,P<0.001)and serum PRL level was a protective factor for NAFLD(OR 0.944,95%CI 0.921-0.968,P<0.001).Mediation analysis showed that serum PRL played a partial mediating role between menopausal status and NAFLD in women,with proportion mediated 36.88%.Conclusion Lower serum prolactin is a mediator of the association between NAFLD and menopausal status in women hospitalized in the Endocrinology Department.

关 键 词：绝经 非酒精性脂肪性肝病 催乳素 

分 类 号：R575.5[医药卫生—消化系统]