摘要
背景非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)是我国最常见肝脏疾病,维生素D、正五聚体蛋白3(pentraxin 3,PTX3)能通过调节调节钙磷代谢、炎症参与NAFLD发生发展.本研究分析NAFLD患者血清25羟维生素D3[25-hydroxy vitamin D3,25(OH)D3]、PTX3水平与肝脂肪含量及肝纤维化的关系.目的分析血清25(OH)D3、PTX3与NAFLD患者肝脂肪含量的关系及诊断肝纤维化的价值.方法选取2022-06/2023-09我院120例NAFLD患者作为研究组,另选同期120例健康体检者作为对照组.比较两组一般资料、血清25(OH)D3、PTX3水平,并比较研究组不同肝脂肪含量患者血清25(OH)D3、PTX3水平,分析血清25(OH)D3、PTX3水平与NAFLD患者肝脂肪含量的相关性,并比较研究组不同肝纤维化程度患者血清25(OH)D3、PTX3、肝纤维化及肝功能指标[透明质酸(hyaluronic acid,HA)、Ⅲ型胶原前(procollagen typeⅢ,PCⅢ)、Ⅳ型前胶原(procollagen typeⅣ,PCⅣ)、丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)]水平,分析血清25(OH)D3、PTX3水平与肝纤维化、肝功能指标的相关性、诊断肝纤维化的价值.结果研究组血清25(OH)D3水平低于对照组,PTX3水平高于对照组(P<0.05);研究组不同肝脂肪含量患者血清25(OH)D3、PTX3水平比较差异有统计学意义(P<0.05),随着肝脂肪含量增加,血清25(OH)D3水平明显降低,PTX3水平明显升高;血清25(OH)D3与NAFLD患者肝脂肪含量呈负相关,PTX3水平与NAFLD患者肝脂肪含量呈正相关(P<0.05);研究组肝纤维化患者血清25(OH)D3水平低于无肝纤维化患者,PTX3、HA、PCⅢ、PCⅣ、ALT、AST水平高于无肝纤维化患者(P<0.05);NAFLD患者血清25(OH)D3水平与HA、PCⅢ、PCⅣ、ALT、AST水平呈负相关,PTX3水平与HA、PCⅢ、PCⅣ、ALT、AST水平呈正相关(P<0.05);血清25(OH)D3、PTX3单独诊断NAFLD患者肝纤维化的曲线下面积(area under the curve,AUC)分别为0.713、0.781,联合诊断的AUC为0.908,大于二者单独诊断的AUC(P<0.05).结论NAFLD患者血清25(OH)D3水平与肝脂肪含量呈负相关,血清PTX3水平与肝脂肪含量呈正相关,二者在肝纤维化诊断方面具有一定价值.
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common liver disease in China.Vitamin D and pentraxin 3(PTX3)participate in the occurrence and development of NAFLD by regulating calcium and phosphorus metabolism and inflammation.This study analyzed the relationship of serum 25-hydroxy vitamin D3[25(OH)D3]and PTX3 levels with liver fat content and liver fibrosis in patients with NAFLD.AIM To analyze the relationship of serum 25(OH)D3 and PTX3 with liver fat content in patients with NAFLD,as well as their diagnostic value for liver fibrosis.METHODS A total of 120 NAFLD patients in our hospital from June 2022 to September 2023 were selected as a study group,and another 120 healthy individuals in the same period were selected as a control group.General information and serum levels of 25(OH)D3 and PTX3 were compared between and two groups,and the levels of 25(OH)D3 and PTX3 were compared in patients with different liver fat contents in the study group.The correlation between serum levels of 25(OH)D3 and PTX3 and liver fat content in NAFLD patients was analyzed.The levels of serum 25(OH)D3,PTX3,liver fibrosis,and liver function indicators[hyaluronic acid(HA),procollagen typeⅢ(PCⅢ),procollagen typeⅣ(PCIV),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)]were compared among patients with different degrees of liver fibrosis in the study group.The correlation of serum 25(OH)D3 and PTX3 levels with liver fibrosis and liver function indicators was examined,and their value for diagnosing liver fibrosis was assessed.RESULTS Serum 25(OH)D3 level in the study group was lower than that of the control group,while PTX3 level was higher than that of the control group(P<0.05).There was a statistically significant difference in serum 25(OH)D3 and PTX3 levels among patients with different liver fat contents in the study group(P<0.05).As the liver fat content increased,serum 25(OH)D3 levels significantly decreased,while PTX3 levels significantly increased.Serum 25(OH)D3 levels were negatively correlated with liver fat content in NAFLD patients,while PTX3 levels were positively correlated with liver fat content in NAFLD patients(P<0.05).Serum 25(OH)D3 levels in patients at risk of liver fibrosis in the study group were lower than those in patients without liver fibrosis,while the levels of PTX3,HA,PCⅢ,PCⅣ,ALT,and AST were higher than those of patients without liver fibrosis(P<0.05).Serum 25(OH)D3 levels in NAFLD patients were negatively correlated with HA,PCⅢ,PCⅣ,ALT,and AST levels,while PTX3 levels were positively correlated with HA,PCⅢ,PCⅣ,ALT,and AST levels(P<0.05).The area under the curve(AUC)of serum 25(OH)D3 and PTX3 alone for diagnosing liver fibrosis in patients with NAFLD was 0.713 and 0.781,respectively,while the AUC of their combination was 0.908,which was greater than the AUC of either of them alone(P<0.05).CONCLUSION Serum 25(OH)D3 level in NAFLD patients is negatively correlated with liver fat content,while serum PTX3 level is positively correlated with liver fat content.The two have appreciated diagnostic value in liver fibrosis.
作者
戴简吉
邓旖
王国峰
林开勤
何建荣
胡晓钢
Jian-Ji Dai;Yi Deng;Guo-Feng Wang;Kai-Qin Lin;Jian-Rong He;Xiao-Gang Hu(Department of Oncology and Vascular Intervention,Jinhua Central Hospital,Jinhua 321000,Zhejiang Province,China)
出处
《世界华人消化杂志》
2025年第3期192-198,共7页
World Chinese Journal of Digestology
基金
金华市科技计划项目,No.2024D551107。
