摘要
目的探讨非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)与血清Ⅰ型原胶原氨基端前肽(procollagen type 1 N-terminal propeptide,P1NP)、Ⅰ型胶原交联羧基端肽β特殊序列(β-C-terminal peptide of typeⅠcollagen,β-CTX)之间的相关性。方法依据2018年中国《非酒精性脂肪性肝病防治指南》的诊断及排除标准,筛选符合条件的研究对象,设立NAFLD组(n=44),同时选择相匹配的健康人群设立对照组(n=46),测量身高、体重、腰围、臀围,计算体质量指数(body mass index,BMI)及腰臀比(waist hip rate,WHR)。采集空腹肘静脉血检测丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸基转移酶(aspartate aminotransferase,AST)、γ-谷氨酰基转移酶(gamma-glutamyltransferase,GGT)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、空腹胰岛素(fasting insulin,FIns)、血尿素氮(blood urea nitrogen,BUN)、肌酐(creatinine,Cr)、血钙(calcium,Ca)、血磷(phosphorus,P)、25-羟维生素D_(3)[25-hydroxyvitamin D_(3),25-(OH)D_(3)]、P1NP、β-CTX。计算胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)。结果与对照组比较,NAFLD组患者BMI、WHR、ALT、AST、GGT、FPG、HbA1c、TG、TC、LDL-C、FIns、HOMA-IR显著升高[BMI:(26.62±2.76)kg/m 2 vs.(22.63±2.67)kg/m 2,P<0.05;WHR:(0.91±0.06)vs.(0.81±0.07),P<0.05;ALT:(39.95±27.27)U/L vs.(18.91±8.73)U/L,P<0.05;AST:(34.86±22.42)U/L vs.(18.91±8.74)U/L,P<0.05;GGT:(40.26±22.84)U/L vs.(30.62±15.60)U/L,P<0.05;FPG:(4.88±0.51)mmol/L vs.(4.67±0.40)mmol/L,P<0.05;HbA1c:(4.69±0.25)%vs.(4.58±0.20)%,P<0.05;TG:(2.14±1.12)mmol/L vs.(1.33±0.61)mmol/L,P<0.05;TC:(5.27±1.16)mmol/L vs.(4.67±0.71)mmol/L,P<0.05;LDL-C:(3.34±0.87)mmol/L vs.(2.81±0.61)mmol/L,P<0.05;FIns:(16.42±4.92)μIU/ml vs.(12.20±4.74)μIU/mL,P<0.05;HOMA-IR:(3.57±1.13)vs.(2.55±1.07),P<0.05],25-(OH)D_(3)、P1NP显著降低[25-(OH)D_(3):(22.85±8.05)ng/mL vs.(27.45±6.52)ng/mL,P<0.05;P1NP:(35.72±5.35)ng/mL vs.(42.77±7.54)ng/mL,P<0.05]。相关性分析结果显示,P1NP与BMI、WHR、FPG、HbA1c、ALT、AST、GGT、TG呈负相关(r值分别为-0.376、-0.318、-0.246、-0.246、-0.384、-0.420、-0.276、-0.267,均P<0.05);与25(OH)D_(3)、β-CTX呈正相关(r值分别为0.263、0.598,均P<0.05)。调整混杂因素后P1NP仍与ALT、AST、GGT、TG呈显著负相关(P<0.05)。结论NAFLD患者血清25-(OH)D_(3)、P1NP显著降低,筛查其血清浓度变化对NAFLD人群骨质疏松症的防治有一定的临床价值。
Objective To investigate the correlation between non-alcoholic fatty liver disease(NAFLD)and serum type Ⅰ procollagen N-telopeptide(P1NP)andβ-C-terminal peptide of typeⅠcollagen(β-CTX).Methods Eligible subjects were divided into two groups:NAFLD group(n=44)and control group(n=46).Height,weight,waist circumference and hip circumference were measured,body mass index(BMI)and waist-to-hip ratio(WHR)were calculated.Fasting elbow venous blood was collected to detect alanine aminotransferase(ALT),aspartate transferase(AST),γ-glutamyltransferase(GGT),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting insulin(FIns),blood urea nitrogen(BUN),creatinine(Cr),serum calcium(Ca),serum phosphorus(P),25-hydroxyvitamin D_(3)[25(OH)D_(3)],P1NP,β-CTX.Insulin resistance index(HOMA-IR)was calculated.Results Compared with the control group,BMI,WHR,ALT,AST,GGT,FPG,HbA1c,TG,TC,LDL-C,FIns,and HOMA-IR were significantly increased[BMI:(26.62±2.76)kg/m 2 vs.(22.63±2.67)kg/m 2,P<0.05;WHR:(0.91±0.06)vs.(0.81±0.07),P<0.05;ALT:(39.95±27.27)U/L vs.(18.91±8.73)U/L,P<0.05;AST:(34.86±22.42)U/L vs.(18.91±8.74)U/L,P<0.05;GGT:(40.26±22.84)U/L vs.(30.62±15.60)U/L,P<0.05;FPG:(4.88±0.51)mmol/L vs.(4.67±0.40)mmol/L,P<0.05;HbA1c:(4.69±0.25)%vs.(4.58±0.20)%,P<0.05;TG:(2.14±1.12)mmol/L vs.(1.33±0.61)mmol/L,P<0.05;TC:(5.27±1.16)mmol/L vs.(4.67±0.71)mmol/L,P<0.05;LDL-C:(3.34±0.87)mmol/L vs.(2.81±0.61)mmol/L,P<0.05;FIns:(16.42±4.92)μIU/ml vs.(12.20±4.74)μIU/ml,P<0.05;HOMA-IR:(3.57±1.13)vs.(2.55±1.07),P<0.05],anD_(2)-(OH)D_(3)and P1NP levels were significantly decreased in NAFLD group[25-(OH)D_(3):(22.85±8.05)ng/mL vs.(27.45±6.52)ng/mL,P<0.05;P1NP:(35.72±5.35)ng/mL vs.(42.77±7.54)ng/mL,P<0.05].The results of correlation analysis showed that P1NP was negatively correlated with BMI,WHR,FPG,HbA1c,ALT,AST,GGT,and TG(r=-0.376,-0.318,-0.246,-0.246,-0.384,-0.420,-0.276,-0.267,all P<0.05).It was positively correlated with 25(OH)D_(3)andβ-CTX(r=0.263,0.598,P<0.05).After adjusting for confounding factors,P1NP was still negatively correlated with ALT,AST,GGT,and TG(P<0.05).Conclusions The levels of serum 25(OH)D_(3)and P1NP in patients with NAFLD are significantly decreased.Screening the changes of serum levels of 25(OH)D_(3)and P1NP in patients with NAFLD has a certain clinical value for the prevention and treatment of osteoporosis.
作者
黄琦
杨培庆
梅腾悦
付华华
王攀
廖鑫
高琳
HUANG Qi;YANG Pei-qing;MEI Teng-yue;FU Hua-hua;WANG Pan;LIAO Xin;GAO Lin(Department of Nuclear Medicine,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,China;Department of Endocrinology,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,China)
出处
《中华骨质疏松和骨矿盐疾病杂志》
CSCD
北大核心
2021年第4期368-373,共6页
Chinese Journal Of Osteoporosis And Bone Mineral Research
基金
合肥市科技计划基金[遵市科合社字(2018)79]。
