腹部定量CT和血清脂肪因子与非酒精性脂肪肝相关性分析  

Correlation analysis between abdominal quantitative CT and serum adipokines with non-alcoholic fatty liver disease

作　　者：陈彦孜 唐湘雍 尹安雨 李建华 于大飞 张玉忠 CHEN Yanzi;TANG Xiangyong;YIN Anyu;LI Jianhua;YU Dafei;ZHANG Yuzhong(Department of Radiology,Shenzhen Longhua District People's Hospital,Shenzhen 518109,China)

机构地区：[1]深圳市龙华区人民医院医学影像科,广东深圳518109

出　　处：《长春中医药大学学报》2025年第2期199-203,共5页Journal of Changchun University of Chinese Medicine

基　　金：深圳市龙华区医疗卫生机构区级科研项目(2020061)。

摘　　要：目的 探讨非酒精性脂肪肝(NAFLD)患者腹部脂肪定量CT(QCT)参数、血清磷脂酰肌醇蛋白聚糖4(Glypican 4)水平与病情程度相关性及其对病情程度的评估价值。方法 回顾性选择2020年1月-2022年1月深圳市龙华区人民医院诊治的66例非酒精性脂肪肝患者作为研究组,另选择同期健康体检者66例作为对照组。比较2组腹部脂肪QCT参数皮下脂肪面积(SAA)、腹部内脏脂肪面积(VAT)、肝脏与脾脏的CT比值(CTL/S值)、血清Glypican 4,分析其与病情程度相关性。评价其对病情程度的评估价值。结果 研究组SAA、VAT及血清Glypican 4、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)水平高于对照组,CTL/S值低于对照组,空腹血糖水平、HOMA-IR高于对照组(P<0.05);SAA、VAT、Glypican 4与病情程度、AST、ALT、HOMA-IR呈正相关,CTL/S值与病情程度、AST、ALT、HOMA-IR呈负相关(P<0.05);SAA、VAT、CTL/S值、Glypican 4联合评估病情程度的AUC>单项指标评估(P<0.05)。结论 非酒精性脂肪肝患者SAA、VAT及血清Glypican 4水平升高,CTL/S值降低,且与病情程度、肝功能、胰岛素抵抗密切相关,联合检测其水平对病情程度具有一定评估价值。Objective To investigate the correlation between abdominal fat quantitative CT(QCT)parameters,serum phosphatidylinositol proteoglycan 4(Glypican 4)level and the severity of non-alcoholic fatty liver disease(NAFLD),and to analyze its evaluation value for disease severity.Methods A total of 66 patients with NAFLD diagnosed and treated in Shenzhen Longhua District People's Hospital from January 2020 to January 2022 were selected as the study group,and another 66 healthy people who underwent physical examinaions during the same period were selected as the control group.The abdominal fat QCT parameters[the area of subcutaneous adipose(SAA),abdominal visceral adipose tissue(VAT),CT ratio of liver and spleen(CTL/S)],and serum Glypican 4 level were compared between two groups,and its value in assessing the severity of the condition was evaluated.Results SAA and VAT,and the levels of serum Glypican 4,aspartate aminotransferase(AST)and alanine aminotransferase(ALT)in the study group were higher than those in the control group,the value of CTL/S was lower than that in the control group,and the fasting blood glucose levels and homeostasis model assessment of insulin resistance(HOMA-IR)in the study group were higher than those in the control group(P<0.05);SAA,VAT and Glypican 4 were positively correlated with disease severity,AST,ALT and HOMA-IR,while CTL/S was negatively correlated with disease severity,AST,ALT and HOMA-IR(P<0.05);The AUC of combined assessment of SAA,VAT,CTL/S value and Glypican 4 level for assessing the severity of the disease was greater than that of single index assessment(P<0.05).Conclusion SAA and VAT,and serum Glypican 4 level in NAFLD patients increase,and the CTL/S decreases,which is closely related to the severity of the disease,liver function and insulin resistance.Combined detection of their levels has certain evaluation value for the severity of the disease.

关 键 词：非酒精性脂肪肝 腹部脂肪定量CT参数 磷脂酰肌醇蛋白聚糖4 病情程度 评估价值 

分 类 号：R575[医药卫生—消化系统]