摘要
目的分析不同程度的非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)与血脂、尿酸(uric acid,UA)及肝功能的相关性。方法选取2020年6月—2021年1月在锦州医科大学附属第一医院健康管理中心体检的374例NAFLD患者作为研究对象。根据瞬时弹性成像技术检测脂肪衰减度(controlled attenuation parameter,CAP),将NAFLD患者分为轻度NAFLD(240 dB/m≤CAP<265 dB/m)、中度NAFLD(265 dB/m≤CAP<295 dB/m)、重度NAFLD(CAP≥295 dB/m),比较不同程度的NAFLD患者的血脂、UA、肝功能;分析NAFLD病情程度与相关临床代谢指标的相关性;采用有序logistic回归模型分析NAFLD严重程度的相关危险因素。结果中度NAFLD患者甘油三酯(triglyceride,TG)、UA、天冬氨酸转氨酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、谷氨酰转肽酶(gamma-glutamyltransferase,GGT)、肝脏硬度值(liver stiffness measurement,LSM)水平高于轻度NAFLD患者,高密度脂蛋白(high density lipoprotein-cholesterol,HDL-C)水平低于轻度NAFLD患者,差异有统计学意义(P<0.05);重度NAFLD患者TG、UA、AST、ALT、GGT、LSM水平高于中度NAFLD患者,差异有统计学意义(P<0.05);重度NAFLD患者TG、UA、AST、ALT、GGT、LSM水平高于轻度NAFLD患者,HDL-C水平低于轻度NAFLD患者,差异有统计学意义(P<0.05);不同程度的NAFLD患者血脂、UA、肝功能各项指标比较,差异有统计学意义(P<0.05)。NAFLD病情程度与TG、UA、ALT、GGT、LSM水平呈正相关(r=0.275、0.339、0.382、0.105、0.522,P<0.05),与HDL-C具有负相关(r=-0.243,P<0.05)。有序logistic回归模型分析结果显示HDL-C、UA、ALT、LSM是不同程度的NAFLD发生的独立危险因素(OR=-3.193、1.005、1.038、2.094,P<0.015、0.001、<0.001、<0.001)。结论不同程度的NAFLD患者脂质紊乱,UA,肝酶水平逐渐升高,且HDL-C、UA、ALT、LSM水平异常在重度NAFLD发生风险最高。
Objective To analyze the correlation between different degrees of non-alcoholic fatty liver disease(NAFLD)and blood lipids,uric acid(UA),and liver function.Methods A total of 374 NAFLD patients who had physical examinations in the Health Management Center of the First Affiliated Hospital of Jinzhou Medical University,China,from June 2020 to January 2021 were selected as subjects.Patients were divided into mild NAFLD(240 dB/m≤controlled attenuation parameter[CAP]<265 dB/m),moderate NAFLD(265 dB/m≤CAP<295 dB/m),and severe NAFLD(CAP≥295 dB/m),based on determination of the CAP by transient elastography.Blood lipids,UA,and liver function of patients with different degrees of NAFLD were compared.The correlation between the severity of NAFLD and related clinical metabolic indicators was analyzed.An ordered logistic regression model was used to analyze the risk factors for NAFLD severity.Results The levels of triglycerides(TG),UA,aspartate aminotransferase(AST),alanine aminotransferase(ALT),gamma-glutamyltransferase(GGT),and the liver stiffness measurement(LSM)in patients with moderate NAFLD were higher than patients with mild NAFLD,while the levels of high density lipoprotein-cholesterol(HDL-C)were lower than patients with mild NAFLD;the differences were statistically significant(P<0.05).The levels of TG,UA,AST,ALT,and GGT,and the LSM in patients with severe NAFLD were higher than patients with moderate NAFLD;the differences were statistically significant(P<0.05).The levels of TG,UA,AST,ALT,and GGT,and the LSM in patients with severe NAFLD were higher than patients with mild NAFLD,while the HDL-C level was lower than patients with mild NAFLD;the differences were statistically significant(P<0.05).There were statistically significant differences in blood lipids,UA,and liver function among patients with different degrees of NAFLD severity(P<0.05).The severity of NAFLD was positively correlated with the levels of TG,UA,ALT,GGT,and LSM(r=0.275,0.339,0.382,0.105,and 0.522,respectively;P<0.05),and negatively correlated with HDL-C(r=-0.243;P<0.05).The results of the ordered logistic regression model showed that HDL-C,UA,ALT,and LSM were independent risk factors for different degrees of NAFLD severity(OR=-3.193,1.005,1.038,and 2.094;P<0.015,0.001,<0.001,and<0.001,respectively).Conclusion Lipid disorders,UA,and liver enzyme levels are gradually increased in patients with different degrees of NAFLD severity.Abnormal HDL-C,UA,ALT,and LSM levels are the most significant risk factors for severe NAFLD.
作者
王惠颖
徐锦江
WANG Hui-ying;XU Jin-jiang(Jinzhou Medical University,Jinzhou 121000,China;不详)
出处
《慢性病学杂志》
2022年第2期216-220,共5页
Chronic Pathematology Journal
关键词
非酒精性脂肪肝
血脂
尿酸
肝功能
代谢指标
Non-alcoholic fatty liver disease
Blood lipids
Uric acid
Hepatic function
Metabolic parameters
