非酒精性脂肪性肝病合并颈动脉粥样硬化斑块患者血清IL-17、IFN-γ和IL-6变化及其临床意义探讨  

Changes of serum IL-17, IFN-γ and IL-6 levels in patients with nonalcoholic fatty liver disease and carotid atherosclerotic plaques

作　　者：郑慧慧 王玉蓉 宰国田[2] Zheng Huihui;Wang Yurong;Zai Guotian(Clinical Laboratory,Jiangbei Hospital Affiliated to Nantong University,Nanjing 210048,Jiangsu Province,China)

机构地区：[1]南通大学附属南京江北医院检验科,南京市210048 [2]南通大学附属南京江北医院内分泌科,南京市210048

出　　处：《实用肝脏病杂志》2025年第1期56-59,共4页Journal of Practical Hepatology

基　　金：南京市卫生科技发展专项资金资助项目(编号:YKK21212)。

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)患者血清白细胞介素(IL)-17、γ-干扰素(IFN-γ)和IL-6水平变化及其与颈动脉粥样硬化斑块形成(CAS)的关系。方法2022年9月~2024年8月我院收治的NAFLD患者122例,使用超声检查诊断CAS,采用流式荧光发光法检测血清IL-17、IL-6和IFN-γ水平。应用二元Logistic回归分析NAFLD患者发生CAS的影响因素。结果本组NAFLD患者CAS发生率为46.7%;57例NAFLD合并CAS患者收缩压(SBP)、舒张压(DBP)、体质指数(BMI)、合并糖尿病、高血压和冠心病比率、空腹血糖(FPG)和血清尿酸(UA)水平均显著高于未合并CAS患者,差异有统计学意义(P<0.05);NAFLD合并CAS患者血清IL-17和IL-6水平分别为(51.2±8.6)pg/ml和(17.9±6.5)ng/ml,均显著高于未合并CAS患者【分别为(42.1±7.3)pg/ml和(12.1±3.2)ng/ml,P<0.05】,而血清IFN-γ水平为(171.0±23.4)ng/L,显著低于NAFLD未合并CAS患者【(220.0±33.2)ng/L,P<0.05】;两组血脂水平差异也有统计学意义(P<0.05);多因素Logistic回归分析显示,血清IL-17(OR=1.530,95%CI:1.133~2.064)、IFN-γ(OR=1.489,95%CI:1.170~1.895)、IL-6(OR=1.511,95%CI:1.144~1.996)、高脂血症(OR=1.578,95%CI:1.160~2.146)和糖尿病(OR=1.611,95%CI:1.112~2.334)均是影响NAFLD患者发生CAS的独立危险因素(P<0.05)。结论NAFLD患者可能更易发生CAS,除了存在血脂升高的危险因素外,细胞因子可能也参与了发病过程。Objective The aim of this study was to explore implications of serum interleukin-17(IL-17),γ-interferon(IFN-γ)and interleukin-6(IL-6)level changes in patients with nonalcoholic fatty liver disease(NAFLD)and carotid atherosclerosis(CAS).Methods A total of 122 patients with NAFLD were enrolled in our hospital between September 2022 and August 2024.Serum IL-17,IL-6 and IFN-γlevels were detected by flow fluorescent luminescence,and CAS was testified by ultrasonography.The influencing factors of CAS occurrence were analyzed by binary Logistic regression analysis.Results Prevalence of CAS in our series was 46.7%;there were significant differences as respect to blood pressure,body mass index,concomitant diabetes,coronary heart disease,fasting plasma glucose and uric acid between patients with and without CAS(P<0.05);serum IL-17 and IL-6 levels in patients with NAFLD and CAS were(51.2±8.6)pg/ml and(17.9±6.5)ng/ml,both significantly higher than[(42.1±7.3)pg/ml and(12.1±3.2)ng/ml,respectively,P<0.05],while serum IFN-γlevel was(171.0±23.4)ng/L,significantly lower than[(220.0±33.2)ng/L,P<0.05]in those without CAS;there was also a significant difference respect to blood fat levels between the two groups(P<0.05);multivariate Logistic regression analysis showed that serum IL-17(OR=1.530,95%CI:1.133-2.064),IFN-γ(OR=1.489,95%CI:1.170-1.895),IL-6(OR=1.511,95%CI:1.144-1.996),hyperlipidemia(OR=1.578,95%CI:1.160-2.146)and diabetes(OR=1.611,95%CI:1.112-2.334)were all the independent risk factors for CAS occurrence(P<0.05).Conclusion NAFLD patients could have more probability of CAS,which might be related to hyperlipidemia and cytokine involvement.

关 键 词：非酒精性脂肪性肝病 颈动脉粥样硬化斑块 Γ-干扰素 白细胞介素-17 白细胞介素-6 

分 类 号：R543.4[医药卫生—心血管疾病] R575.5[医药卫生—内科学]