非酒精性脂肪性肝病伴肥胖患者血清25羟维生素D的表达及其临床意义  

Expression of serum 25-hydroxyvitamin D and its clinical significance in patients with nonalcoholic fatty liver disease and obesity

作　　者：武琳琳 张帆[1] WU Linlin;ZHANG Fan(Department of Microbiology and Immunology,Shanxi Medical University,Taiyuan 030001,China;Department of Clinical Laboratory,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,The Third Hospital of Shanxi Medical University,Tongji Shanxi Hospital,Taiyuan 030032,China)

机构地区：[1]山西医科大学微生物学与免疫学教研室,太原030001 [2]山西白求恩医院(山西医学科学院),山西医科大学第三医院,同济山西医院检验科,太原030032

出　　处：《临床肝胆病杂志》2024年第7期1349-1353,共5页Journal of Clinical Hepatology

基　　金：山西省自然科学基金(202203021211239)。

摘　　要：目的检测非酒精性脂肪性肝病(NAFLD)伴肥胖患者血清25羟维生素D的表达水平,分析25羟维生素D与机体肝功能、血脂及炎症指标的关系。方法选取2022年1月—2023年3月于山西白求恩医院就诊的NAFLD患者90例,根据BMI分为NAFLD伴肥胖组60例(BMI≥28 kg/m^(2))和NAFLD组30例(BMI<28 kg/m^(2));另选取同期健康体检者30例作为对照组。检测3组人群血清25羟维生素D、肝功能指标(ALT、AST、ALP、GGT、TBil、DBil)、血脂指标(HDL、LDL、TC、TG)、炎症指标(H-CRP、GP-73)以及细胞因子水平(IL-2、IL-4、IL-6、IL-10、IL-17、IL-1β、TNF-α、IFN-γ),测量肝脾体积比值。正态分布的计量资料多组间比较采用单因素方差分析,进一步两两比较采用LSD-t检验或Tamhane’s T2法;非正态分布的计量资料多组间比较及进一步两两比较均采用Kruskal-Wallis H检验。相关性采用Pearson或Spearman相关性分析。结果与对照组相比,NAFLD伴肥胖组25羟维生素D,HDL,细胞因子IL-2、IL-4、IL-10、IFN-γ和肝脾体积比值均显著降低(P值均<0.05),而肝功能指标ALT、AST、ALP、GGT、TBil、DBil,血脂指标LDL、TC、TG,炎症指标H-CRP、GP-73及细胞因子IL-1β、IL-17、TNF-α均明显升高(P值均<0.05)。NAFLD伴肥胖组与NAFLD组比较,除肝脾体积比值和H-CRP水平外,上述指标差异均有统计学意义(P值均<0.05)。相关性分析结果显示,25羟维生素D水平与ALT(r=-0.324,P=0.012)、AST(r=-0.421,P=0.001)、ALP(r=-0.435,P=0.001)、GGT(r=-0.343,P=0.007)、TBil(r=-0.532,P<0.001)、DBil(r=-0.521,P<0.001)、LDL(r=-0.405,P=0.001)、TC(r=-0.466,P<0.001)、TG(r=-0.551,P<0.001)、H-CRP(r=-0.434,P=0.014)、GP-73(r=-0.421,P=0.001)、IL-1β(r=-0.433,P=0.001)、IL-17(r=-0.465,P<0.001)和TNF-α(r=-0.533,P<0.001)呈负相关;与HDL(r=0.632,P<0.001)、IL-2(r=0.546,P<0.001)、IL-4(r=0.533,P<0.001)、IL-10(r=0.456,P<0.001)及肝脾体积比值(r=0.543,P<0.001)呈正相关。结论NAFLD伴肥胖患者血清25羟维生素D与肝功能、血脂及�Objective To investigate the serum level of 25-hydroxyvitamin D in patients with nonalcoholic fatty liver disease(NAFLD)and obesity,as well as the correlation of 25-hydroxyvitamin D with liver function,blood lipids,and inflammatory indicators.Methods A total of 90 patients with NAFLD who attended Shanxi Bethune Hospital from January 2022 to March 2023 were enrolled,and according to the body mass index(BMI),they were divided into NAFLD+obesity group with 60 patients(BMI≥28 kg/m^(2))and NAFLD group with 30 patients(BMI<28 kg/m^(2));30 individuals who underwent physical examination during the same period of time were enrolled as control group.Related indications were measured for all three groups,including serum 25-hydroxyvitamin D,liver function parameters(alanine aminotransferase[ALT],aspartate aminotransferase[AST],alkaline phosphatase[ALP],gamma-glutamyl transpeptidase[GGT],total bilirubin[TBil],and direct bilirubin[DBil]),blood lipid parameters(high-density lipoprotein[HDL],low-density lipoprotein[LDL],total cholesterol[TC],and triglyceride[TG]),inflammatory indicators(high-sensitivity C-reactive protein[H-CRP]and Golgi protein 73[GP-73]),cytokines(interleukin-2[IL-2],interleukin-4[IL-4],interleukin-6[IL-6],interleukin-10[IL-10],interleukin-17[IL-17],interleukin-1β[IL-1β],tumor necrosis factor-α[TNF-α],and interferon gamma[IFN-γ]),and liver/spleen volume ratio.A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the least significant difference t-test or the Tamhane’s T2 test was used for further comparison between two groups;the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and further comparison between two groups.A Pearson or Spearman correlation analysis was performed.Results Compared with the control group,the NAFLD+obesity group had significant reductions in 25-hydroxyvitamin D,HDL,cytokines(IL-2,IL-4,IL-10,and IFN-γ),and liver/spleen volume ratio(all P<0.05),

关 键 词：非酒精性脂肪性肝病 肥胖症 25羟维生素D 

分 类 号：R575.5[医药卫生—消化系统] R589.2[医药卫生—内科学]