血清高分子量脂联素在非酒精性脂肪性肝病患者中的检测意义

摘要/Abstract

摘要： 目的探讨血清高分子量脂联素(HMW-APN)在非酒精性脂肪性肝病(NAFLD)患者中的变化及其临床意义。方法 2017年1月至2020年1月收治NAFLD 106例(NAFLD组)(男74例、女32例),年龄(43.5±6.7)岁。收集健康受试者100例(对照组)(男66例、女34例),年龄(42.5±7.8)岁。计量资料采用t检验,计数资料采用卡方检验,Pearson相关性分析探讨相关性;Logistic回归分析探讨NAFLD发生的影响因素。结果比较NAFLD组、对照组一般资料,NAFLD组BMI为(26.1±2.3)kg/m²,对照组BMI为(23.4±2.3)kg/m²,两组具有显著性差异(P<0.05);NAFLD组HMW-APN为(1.8±2.1)μg/mL,对照组HMW-APN为(3.2±2.6)μg/mL,两组具有显著性差异(P<0.05);NAFLD组TG为(1.6±0.7)mmol/L,对照组TG为(1.2±0.5)mmol/L,两组具有显著性差异(P<0.05);NAFLD组TC为(4.7±0.8)mmol/L,对照组TC为(4.1±0.6)mmol/L,两组具有显著性差异(P<0.05);NAFLD组LDL-C为(1.8±0.5)mmol/l,对照组LDL-C为(1.6±0.5)mmol/L,两组具有显著性差异(P<0.05);NAFLD组HDL-C为(1.4±0.3)mmol/L,对照组HDL-C为(1.2±0.2)mmol/L,两组具有显著性差异(P<0.05);NAFLD组FBG为(5.1±0.5)mmol/L,对照组FBG为(4.7±0.4)mmol/L,两组具有显著性差异(P<0.05);NAFLD组HbAIC为(13.3±3.0)%,对照组HbAIC为(5.5±1.4)%,两组具有显著性差异(P<0.05);而两组受试者腰臀比、AST及ALT无显著性差异(P>0.05)。Pearson相关性分析表明,血清HMW-APN水平与TG(r=-0.402)、TC(r=-0.176)、LDL-C(r=-0.148)、FBG(r=-0.374)及HbAIC(r=-0.485)呈显著性负相关(P<0.05),而与HDL-C(r=0.316)呈显著性正相关(P<0.05)。以是否发生NAFLD为因变量(是=1,否=0),多因素Logistic回归分析提示HMW-APN是NAFLD发生的保护性因素(P<0.05),而BMI、TG、TC、FPG及HbAIC是独立危险因素(P<0.05)。结论血清HMW-APN在NAFLD患者中显著降低,高水平血清HMW-APN是NAFLD的保护性因素,而低水平血清HMW-APN或可预测NAFLD发生。

关键词: 非酒精性脂肪性肝病, 高分子量脂联素, Pearson相关性分析, Logistic回归分析

Abstract: Objective To investigate the changes and clinical significance of serum high molecular weight adiponectin (HMW-APN) in patients with nonalcoholic fatty liver disease (NAFLD).Methods From Jan 2017 to Jan 2020,106 patients with NAFLD (NAFLD group) (74 males and 32 females), aged (43.5±6.7) years old, were admitted to our hospital. A total of 100 healthy patients (control group) (66 males and 34 females) with an age of (42.5±7.8) years old were collected. T-test was used for measurement data, chi-square test was used for counting data, Pearson correlation analysis was used to explore the correlation, and Logistic regression analysis was used to explore the influencing factors of NAFLD.Results Comparing the general data of NAFLD group and control group, the BMI of NAFLD group was (26.1±2.3) kg/m², while that of control group was (23.4±2.3) kg/m², with significant difference between the two groups (P<0.05). The HMW-APN in NAFLD group was (1.8±2.1) μg/mL, while that in control group was (3.2±2.6) μg/mL, with significant difference between the two groups (P<0.05). The TG of NAFLD group was (1.6±0.7) mmol/L, while that of control group was (1.2±0.5) mmol/L, with significant difference between the two groups (P<0.05). TC in NAFLD group was (4.7±0.8) mmol/L, while that in control group was (4.1±0.6) mmol/L, with significant difference between the two groups (P<0.05). LDL-C in NAFLD group was (1.8±0.5) mmol/l while LDL-C in control group was (1.6±0.5) mmol/L, with significant difference between the two groups (P<0.05). HDL-C in NAFLD group was (1.4±0.3) mmol/L, while HDL-C in control group was (1.2±0.2) mmol/L, with significant difference between the two groups (P<0.05). The FBG in NAFLD group was (5.1±0.5) mmol/L, while that in control group was (4.7±0.4) mmol/L, with significant difference between the two groups (P<0.05). HbAIC in NAFLD group was (13.3±3.0)% and that in control group was (5.5±1.4)%, with significant difference between the two groups (P<0.05). However, there was no significant difference in waist-hip ratio, AST and ALT between the two groups (P>0.05). Pearson correlation analysis showed that serum HMW-APN level was significantly negatively correlated with TG (r=-0.402), TC (r=-0.176), LDL-C (r=-0.148), FBG (r=-0.374) and HbAIC (r=-0.485) (P<0.05), while was significantly positively correlated with HDL-C (r=0.316) (P<0.05). Taking the occurrence of NAFLD as dependent variable (yes = 1, no = 0), multivariate Logistic regression analysis showed that HMW-APN was a protective factor for NAFLD, while BMI, TG, TC, FPG and HbAIC were independent risk factors.Conclusion Serum HMW-APN is significantly reduced in NAFLD patients. High level serum HMW-APN is a protective factor for NAFLD, while low level serum HMW-APN may predict NAFLD occurrence.

Key words: Nonalcoholic fatty liver disease, High molecular weight adiponectin, Pearson correlation analysis, Logistic regression analysis

徐建浩, 居峰, 章艳. 血清高分子量脂联素在非酒精性脂肪性肝病患者中的检测意义[J]. 肝脏, 2020, 25(12): 1313-1316.

XU Jian-hao, JU Feng, ZHANG Yan. Significance of serum high molecular weight adiponectin in patients with non-alcoholic fatty liver disease[J]. Chinese Hepatolgy, 2020, 25(12): 1313-1316.

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