[1]延 华a,李 敏b.NAFLD 患者血清25(OH)D3，Vaspin 和AIP 水平及其与疾病严重程度的相关性研究[J].现代检验医学杂志,2023,38(06):125-130.[doi:10.3969/j.issn.1671-7414.2023.06.023]
　YAN Huaa,LI Minb.Serum Vitamin D, Vaspin, AIP Levels and Their Correlation with Disease Severity in Patients with NAFLD[J].Journal of Modern Laboratory Medicine,2023,38(06):125-130.[doi:10.3969/j.issn.1671-7414.2023.06.023]
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NAFLD 患者血清25(OH)D3，Vaspin 和AIP 水平及其与疾病严重程度的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
125-130
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Serum Vitamin D, Vaspin, AIP Levels and Their Correlation with Disease Severity in Patients with NAFLD
文章编号:
1671-7414（2023）06-125-06
作者:
延 华a; 李 敏b
（陕西省人民医院 a. 老年病科；b. 保健办，西安 710068）
Author(s):
YAN Huaa; LI Minb
（a.Departments of Geriatrics; b. Health Care Office, Shaanxi Provincial People’s Hospital, Xi’an 710068, China）
关键词:
非酒精性脂肪性肝病; 25- 羟维生素D3; 内脏脂肪特异性丝氨酸蛋白酶抑制剂; 血浆动脉粥样硬化指数
分类号:
R575.5；R446.11
DOI:
10.3969/j.issn.1671-7414.2023.06.023
文献标志码:
A
摘要:
目的 探讨非酒精性脂肪性肝病(non alcoholic fatty liver disease，NAFLD) 患者血清25- 羟维生素D3[25-hydroxyvitamin D3，25-(OH)D3]、内脏脂肪特异性丝氨酸蛋白酶抑制剂（Vaspin），血浆动脉粥样硬化指数(atherogenic index ofplasma，AIP) 水平及其与疾病严重程度之间的关系。方法 收集2021 年1 月～ 2023 年1 月陕西省人民医院收治的112例NAFLD 患者及同期健康体检人群110 例作为研究对象。根据B 超检查结果进一步将NAFLD 分为轻度（n=52）、中度（n=38）和重度（n=22）脂肪肝组。测量所有研究对象身高、体重、腰围（WC）和臀围，计算体质量指数（BMI）及腰臀比（WHR）。采用自动生化分析仪测定空腹血糖（FPG）、空腹胰岛素（FINS）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白- 胆固醇（LDL-C）、高密度脂蛋白- 胆固醇（HDL-C）、丙氨酸氨基转移酶（ALT）和天门冬氨酸氨基转移酶（AST）。采用酶联免疫吸附试验（ELISA）测定25(OH)D3 和Vaspin 水平，计算胰岛素抵抗指数（HOMA-IR）和AIP。分析NAFLD 与健康对照组之间、不同严重程度NAFLD 患者上述指标的差异。多因素Logistic 回归分析影响NAFLD 严重程度的因素。偏相关分析25-(OH)D3 水平、Vaspin ，AIP 和NAFLD 严重程度之间的相关性。结果 112 例NAFLD患者中有78 例（69.6%）患者25(OH)D3 缺乏或不足，NAFLD患者Vaspin，25(OH)D3 和AIP平均水平为7.12±2.36ng/ml，17.24±5.56ng/ml 和0.68±0.13。与对照组比较，NAFLD 组患者BMI，WHR，TG，TC，LDL-C，ALT，AIP 和HOMA-IR 升高（t=2.323，2.145，3.267，2.532，3.128，3.134，2.625，5.041），而Vaspin，25-(OH)D3 水平降低（t=4.542，5.163），差异具有统计学意义（均P<0.05）。与轻、中度NAFLD 患者比较，重度患者 BMI，WHR，TG，ALT，AIP 和HOMA-IR升高，而Vaspin，25-(OH)D3 水平降低，差异具有统计学意义（F=8.645 ～ 76.742，均P<0.05）。Logistic 多因素分析显示BMI（OR=1.922，95%CI：1.175 ～ 3.143），TG（OR=2.464，95%CI：1.263 ～ 4.807），AIP（OR=1.146, 95%CI：1.045 ～ 1.257）和HOMA-IR(OR=1.298，95%CI：1.046 ～ 1.612) 为NAFLD 危险因素，而Vaspin（OR=0.26, 95%CI：0.097 ～ 0.698）和25-(OH)D3(OR=0.271, 95%CI：0.099 ～ 0.600) 为保护性因素。偏相关分析显示25-(OH)D3 浓度与Vaspin 水平之间呈正相关（r=0.53，P<0.01），而与AIP，ALT，AST 和HOMA-IR 呈负相关（r=-0.32，-0.26，-0.34，-0.27，均P <0.01）。结论 NAFLD 患者血清25-(OH) D3，Vaspin 低表达、AIP 高表达与NAFLD 相关并影响肝脏脂肪变。25-(OH)D3 是NAFLD 一种潜在的药物靶点，对NAFLD 防治具有指导意义。
Abstract:
Objective To investigate the relationship between serum 25-hydroxy vitamin D3[25-(OH)D3] levels and adipofactor Vaspin and plasma atherosclerosis index (AIP) in patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of 112 patients with NAFLD admitted to Shaanxi Provincial People’s Hospital from January 2021 to January 2023 and 110 healthy people in the same period were collected as the study objects. According to the results of B-ultrasound, NAFLD was further divided into mild (n=52), moderate (n=38) and severe (n=22) fatty liver groups. Height, weight, waist circumference (WC) and hip circumference of all subjects were measured, and body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Fasting blood glucose (FPG), fasting insulin (FINS), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined by automatic biochemical analyzer. The levels of 25-(OH)D3 and Vaspin were determined by enzymelinked immunosorbent assay (ELISA), and insulin resistance index (HOMA-IR) and AIP were calculated. The differences of the above indexes in NAFLD patients with different severity were analyzed between the healthy control group and NAFLD patients. Multivariate Logistic regression analysis of the factors affecting the severity of NAFLD. Partial correlation analysis was performed for correlations between 25-(OH)D3 levels, Vaspin, AIP, and NAFLD severity. Results Among the 112 NAFLD patients, 78 (69.6%) were deficient or insufficient in 25-(OH)D3, and the Vaspin, 25 (OH)D3 and AIP mean level in NAFLD patients was 7.12±2.36ng/ml,，17.24±5.56ng/ml and 0.68±0.13. Compared with the control group, BMI, WHR, TG, TC, LDL-C，ALT，AIP and HOMA-IR in NAFLD group(t=2.323, 2.145, 3.267, 2.532, 3.128, 3.134, 2.625, 5.041) were increased, while Vaspin，25-(OH)D3 levels were decreased(t=4.542, 5.163), in which the differences were statistical significance (all P<0.05). Compared with patients with mild and moderate NAFLD, BMI, WHR, TG, ALT, AIP and HOMA-IR were increased in patients with severe NAFLD, while Vaspin, 25-(OH)D3 levels were decreased, with statistical significance (F=8.645~76.742, all P<0.05). Logistic multivariate analysis showed that BMI (OR=1.922, 95%CI：1.175-3.143), TG (OR=2.464, 95%CI： 1.263 ～ 4.807), AIP (OR= 1.146, 95%CI：1.045 ～ 1.257) and HOMA-IR(OR=1.298, 95%CI：1.046 ～ 1.612) were risk factors for NAFLD. Vaspin (OR= 0.26, 95%CI：0.097 ～ 0.698) and 25-(OH)D3(OR=0.271, 95%CI：0.099 ～ 0.600) were protective factors. Partial correlation analysis showed that 25-(OH)D3 concentration was positively correlated with Vaspin level (r=0.53, P <0.01), but negatively correlated with AIP, ALT, AST and HOMA-IR (r=-0.32，-0.26，-0.34，-0.27, all P <0.01). Conclusion The low expression of serum 25-(OH) D3，Vaspin，and high expression of AIP in patients with NAFLD are associated with NAFLD and affect liver steatosis. 25-(OH)D3 is a potential drug target for NAFLD and has guiding significance for the prevention and treatment of NAFLD.

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备注/Memo

备注/Memo:
基金项目： 陕西省重点研发项目- 社会发展领域（编号2022SF-450）：腺相关病毒介导的shRNA 下调IGFBP7 对非酒精性脂肪肝的影响；（编号2021SF-352）：基于干部保健十年健康管理模式的团体单位健康管理服务适宜技术研究。
作者简介：延华（1980-），女，硕士，副主任医师，主要从事肝病的基础及临床研究，E-mail：yanhua_lucky@163.com。
通讯作者：李敏(1981-)，女，本科，副主任护师，主要从事老年保健，E-mail：48674346@qq.com。
更新日期/Last Update: 2023-11-15