运动处方联合维生素D对非酒精性脂肪性肝病患者身体形态及生化、影像学指标的影响  

Effects of exercise prescription combined with vitamin D on body morphology,biochemical and imaging indexes in patients with nonalcoholic fatty liver disease

作　　者：王蕾[1] 张利[1] 许素彦 李校天[1] 李芳 杨立杰 WANG Lei;ZHANG Li;XU Suyan;LI Xiaotian;LI Fang;YANG Lijie(Affiliated Hospital of Hebei Engineering University,Handan,Hebei 056002,China)

机构地区：[1]河北工程大学附属医院,河北邯郸056002

出　　处：《中国国境卫生检疫杂志》2024年第4期390-394,435,共6页Chinese Journal of Frontier Health and Quarantine

摘　　要：目的探讨应用运动处方及额外补充维生素D对非酒精性脂肪性肝病患者身体形态及生化、影像学指标的影响及其相关机制。方法选取河北工程大学附属医院2020—2022年门诊就诊的非酒精性脂肪肝患者156例,按照随机数字表法(Random-number Table)分为对照组、维生素D组和运动组及联合组(运动+维生素D),分别给予常规医嘱低脂饮食、低脂饮食基础上口服补充维生素D,低脂饮食基础上配合运动处方、低脂饮食基础上实施运动处方同时联合口服补充维生素D,同时根据不同患者的生活饮食习惯、年龄、性别、身体质量指数、疾病严重程度等多种因素制定个体化饮食干预方案,严格执行3月后通过影像学改变、形体变化及血液生化指标及肝脏脂肪细胞因子的检测判断干预效果。结果对照组总有效率为87.17%,维生素D组总有效率为89.74%,运动组总有效率为94.87%,联合组总有效率为97.43%,联合组总有效率显著超过其余3个组,差异有统计学意义(t=11.703,P<0.01)。干预后,身体形态指标均明显低于本组干预前,差异均有统计学意义(t=3.238,P<0.05)。4组患者在干预后总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平比干预之前降低,而高密度脂蛋白胆固醇比干预之前升高,差异有统计学意义(t=6.489,P<0.05)。维生素D组和对照组相比,干预后TNF-α和NF-κB水平下降,而Irisin和ApN水平升高,差异有统计学意义(t=20.134,P<0.05)。结论在饮食、运动干预的基础上适量补充维生素D,能进一步降低非酒精性脂肪肝患者身体形态及炎性因子水平,改善肝脂质代谢及表型异常,机制可能与维生素D免疫调节作用相关。Objective To investigate the effects of exercise prescription and additional vitamin D supplementation on body morphology,biochemical and imaging indexes in patients with nonalcoholic fatty liver disease and its related mechanisms.Methods A total of 156 patients with nonalcoholic fatty liver disease treated at the Affiliated Hospital of Hebei Engineering University 2020-2022,were divided into control group,vitamin D group,exercise group,combination group(exercise+vitamin D)according to Random-number Table method.They were given low-fat diet as prescribed by conventional doctors,and oral vitamin D supplement based on low-fat diet,respectively.On the basis of low-fat diet combined with exercise prescription,exercise prescription combined with oral vitamin D supplementation was implemented on the basis of low-fat diet.At the same time,individualized dietary intervention plans were formulated according to various factors such as living and eating habits,age,gender,body mass index and disease severity of different patients.After 3 months of strict implementation,the effect of the intervention was judged by imaging changes,physical changes,blood biochemical indexes and liver adipocytokines.Results The total effective rate of the control group was 87.17%,the vitamin D group was 89.74%,the exercise group was 94.87%,and the combined group was 97.43%.The total effective rate of the combined group was significantly higher than that of the other three groups,with statistical significance(t=11.703,P<0.01).After intervention,body shape indexes were significantly lower than those before intervention,and the differences were statistically significant(t=3.238,P<0.05).After intervention,the levels of total cholesterol,triglyceride and low density lipoprotein cholesterol in all the 4 groups were decreased,while high density lipoprotein cholesterol(HDL-C)was increased compared with that of before intervention,with statistical significance(t=6.489,P<0.05).After intervention,the levels of TNF-αand NF-κB in vitamin D group and contro

关 键 词：非酒精性脂肪肝 运动处方 维生素D 胰岛素抵抗 炎性因子 

分 类 号：R575[医药卫生—消化系统]